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The influence of olfactory impairment in vital, independently living older persons on their eating behaviour and food liking
Abstract
These two studies investigated eating behaviour and food liking of independently living Dutch older people with and without olfactory impairment. In the first study, an internet survey was conducted in relation to their olfactory status (n = 512; age 55–91). Hyposmic older people reported eating the same meal more often within a week than their unimpaired peers, and they also differed in some of the types of foods they reported eating as snacks (i.e. fewer cookies and nuts, more candy). In the second study, various strategies to increase food liking among older consumers were investigated, as well as their liking of reformulated foods with an expected reduced palatability. The strategies included (1) combined visual enrichment and flavour enrichment of mashed potatoes, (2) enhancement of taste intensity and thickness of gravy, and (3) flavour enrichment of stews. The reformulation encompassed (1) salt reduction of meatballs and (2) protein enrichment of bread. Thirty-eight young consumers (age 32.3 ± 8.9 y), 41 normosmic older consumers (age 65.1 ± 5.2 y), and 43 hyposmic older consumers (age 68.5 ± 5.9 y) assessed food liking on a 100 mm visual analogue scale. Both older groups increased their food liking in response to the changes made in the mashed potatoes and gravies, decreased their food liking in response to the salt reduction in the meatball and increased their product liking once information was given on the reduction. In conclusion, older persons – regardless of their olfactory status – may respond positively to multi-sensory enrichment in warm meal components. At the same time, certain types of foods may still appeal more or less to hyposmic older persons which in turn may lead to the development of different dietary intake patterns.
... Studies among elderly women revealed that lower olfactory perception was associated with a higher intake of sweets and a lower intake of low-fat milk products, leading to a nutrient intake profile pointing towards a higher risk for cardiac disease [45] and negatively correlated with the consumption of meats, eggs, cereals, and caloric intake, as well as intake of protein, fat, carbohydrates, and minerals [47]. Older adults with olfactory dysfunction were found to choose different snacks than their unimpaired peers [68] and to consume significantly less protein and alcohol, and more carbohydrates than their normosmic counterparts, though their total energy intake was similar [54]. Additionally, older adults with olfactory dysfunction tended to consume more dairy products and meat, and fewer vegetables than younger participants [36], and used more spices to enhance appetite and food intake [47]. ...
... Olfactory dysfunction does not necessarily lead to changes in eating frequency among individuals with acquired olfactory dysfunction, as it was not associated with the number of meals per day nor with the average time spent per meal [67]. Moreover, there was no difference in eating frequency among older adults with olfactory dysfunction when compared to older adults with a normal sense of smell, while those with olfactory dysfunction did consume less varied meals [68]. Moreover, alcohol consumption was less frequent in individuals with olfactory dysfunction than in healthy controls [67]. ...
... In older adults with olfactory dysfunction, variations in the concentration of tea and coffee did not affect the pleasantness of these drinks [44]. While older adults with and without olfactory dysfunction increased food liking in response to multi-sensory enrichment in warm meals (i.e., visual and flavor enrichment in mashed potato) [68], no effects on food liking were observed for flavor and texture enhancement in older adults with olfactory dysfunction [30,69]. However, changes in the texture affected food pleasantness more in older adults with low olfactory ability compared to older adults with a medium or high olfactory ability [69]. ...
... Studies among elderly women revealed that lower olfactory perception was associated with a higher intake of sweets and a lower intake of low-fat milk products, leading to a nutrient intake profile pointing towards a higher risk for cardiac disease [45] and negatively correlated with the consumption of meats, eggs, cereals, and caloric intake, as well as intake of protein, fat, carbohydrates, and minerals [47]. Older adults with olfactory dysfunction were found to choose different snacks than their unimpaired peers [68] and to consume significantly less protein and alcohol, and more carbohydrates than their normosmic counterparts, though their total energy intake was similar [54]. Additionally, older adults with olfactory dysfunction tended to consume more dairy products and meat, and fewer vegetables than younger participants [36], and used more spices to enhance appetite and food intake [47]. ...
... Olfactory dysfunction does not necessarily lead to changes in eating frequency among individuals with acquired olfactory dysfunction, as it was not associated with the number of meals per day nor with the average time spent per meal [67]. Moreover, there was no difference in eating frequency among older adults with olfactory dysfunction when compared to older adults with a normal sense of smell, while those with olfactory dysfunction did consume less varied meals [68]. Moreover, alcohol consumption was less frequent in individuals with olfactory dysfunction than in healthy controls [67]. ...
... In older adults with olfactory dysfunction, variations in the concentration of tea and coffee did not affect the pleasantness of these drinks [44]. While older adults with and without olfactory dysfunction increased food liking in response to multi-sensory enrichment in warm meals (i.e., visual and flavor enrichment in mashed potato) [68], no effects on food liking were observed for flavor and texture enhancement in older adults with olfactory dysfunction [30,69]. However, changes in the texture affected food pleasantness more in older adults with low olfactory ability compared to older adults with a medium or high olfactory ability [69]. ...
Olfaction plays a priming role in both the anticipation and consumption phases of eating behavior. Olfactory dysfunction can therefore lead to changes in various aspects of eating behavior, such as food choice, appetite, and food intake. In light of the increasing prevalence of persistent olfactory dysfunction among patients affected by Covid-19, providing proper care and dietary advice to individuals with olfactory dysfunction is imperative. Therefore, this scoping review seeks to gain a better understanding of the impact of olfactory dysfunction on eating behavior. Following the PRISMA guidelines, 49 papers were included, the outcomes were presented by dividing them into two categories: 1) anticipatory eating behavior, including (anticipatory) food liking, appetite and craving, food preferences, food neophobia, and cooking habits; and 2) consummatory behavior, including, food intake, consumption frequency, adherence to dietary guidelines, (experienced) food liking, food enjoyment, and eating habits. Our results show that in the anticipatory phase of eating behavior, food liking and, food preferences and in the consummatory phase, food enjoyment is most affected in people who experienced a sudden change in olfactory function rather than a gradual decline. Moreover, changes in food flavor perception due to olfactory dysfunction, result in a shift of food preferences towards more taste-based preferences, such as salty or savory (i.e., umami) foods. Subsequently, changes in preferences can affect food intake and adherence to dietary guidelines, but only to a limited extent. Appetite is more likely to be low in individuals with short-term olfactory dysfunction compared to those with long-term changes. Generally, eating behavior is more impacted in individuals with a distorted sense of smell than in those with smell loss, and the effect becomes more pronounced over time. Due to the heterogeneity of methods used to measure different aspects of eating behavior, this review stresses the importance of more research on olfaction and eating behavior using standardized and validated assessments. Such research is essential to better understand the effects of olfactory dysfunction on each aspect of eating behavior and provide effective interventions.
Highlights
Food liking, preferences, and enjoyment are the most affected by olfactory dysfunction
Impact on eating behavior is more pronounced in qualitative vs. quantitative smell loss
Effects of olfactory dysfunction vary by duration and nature (qualitative vs. quantitative)
Standardized, validated methods are needed to assess eating behavior in future studies
There is a crucial need for effective interventions to enhance the eating experience
Graphical Abstract
... One of the physiological factors that affect eating behavior is the decline in olfactory and gustatory function [6][7][8][9][10][11]. Hyposmia is considered a quantitative olfactory deficit indicating a reduced sense of smell [12]. ...
... The olfactory function has a crucial role in human life for avoiding potentially dangerous compounds and for the food taste quality detection and evaluation [13]. A deficit in olfactory function greatly affects food perception and subjects with hyposmia showed a decreased flavor perceptive capacity and food enjoyment, and increased difficulties in detecting spoiled and rotting foods [6][7][8][9][10][11]13,14]. Moreover, changes in dietary behavior (weight gain or loss), problems in personal hygiene, low quality of life, and an increased risk of depression and anxiety have been reported in subjects with olfactory impairment [6][7][8][9][10][11]13,14]. ...
... A deficit in olfactory function greatly affects food perception and subjects with hyposmia showed a decreased flavor perceptive capacity and food enjoyment, and increased difficulties in detecting spoiled and rotting foods [6][7][8][9][10][11]13,14]. Moreover, changes in dietary behavior (weight gain or loss), problems in personal hygiene, low quality of life, and an increased risk of depression and anxiety have been reported in subjects with olfactory impairment [6][7][8][9][10][11]13,14]. Hypogeusia is a quantitative gustatory deficit which (ODi), and odor identification (OId) with the Sniffin' Sticks test [24,32]. ...
Spices and herbs improve sensory perception and acceptance of foods in subjects with chemosensory deficits. Our study demonstrated that aromatic spices/herbs greatly influenced the sensory perception of an aromatic myrtle bitter liqueur (Mirtamaro) in consumers with olfactory and gustatory deficits. Mirtamaro was obtained by infusion of myrtle leaves/berries and a blend of Mediterranean herbs/plants. We initially evaluated differences in gustatory and olfactory perception of pure stimuli in controls (n = 158), subjects with hyposmia (n = 111 participants), and hypogeusia (n = 34). Subjects with hyposmia and hypogeusia showed a marked reduction in odor threshold, discrimination, and identification, while a noticeable compromise in the perception of basic taste modalities (bitter, salty, sour, and sweet) was detected in participants with hypogeusia. Then, in a subpopulation (n = 111) we evaluated differences in the perception of odor and taste pleasantness, intensity, and familiarity of Mirtoamaro. No significant differences emerged, by a labeled hedonic Likert-type scale, in the perception of Mirtamaro odor and taste in subjects with hyposmia and hypogeusia compared to controls. All groups described similar bitter liqueur sensory attributes, qualifying the use of aromatic herbs/plants as a strategy to enhance sensory perception and acceptance of foods in subjects with chemosensory deficits.
... These findings may suggest that methods to enhance the taste of white meats or increase liking for dishes based on white meats would be of value. Taste and liking are known to be important predictors of food intake in older adults [25][26][27]29,30,[38][39][40], and while taste perception is known to deteriorate with age [38][39][40][41], various studies demonstrate increased intakes following the use of flavour enhancers or added flavours in older adults [42][43][44][45][46][47][48][49]. Some consideration for individual preferences, however, is also required; work suggests that not all individuals respond to flavours with increased consump-tion [38,40,41,43,48,49]. ...
... Taste and liking are known to be important predictors of food intake in older adults [25][26][27]29,30,[38][39][40], and while taste perception is known to deteriorate with age [38][39][40][41], various studies demonstrate increased intakes following the use of flavour enhancers or added flavours in older adults [42][43][44][45][46][47][48][49]. Some consideration for individual preferences, however, is also required; work suggests that not all individuals respond to flavours with increased consump-tion [38,40,41,43,48,49]. Flavour use varies widely in the older population [29], as do flavour preferences [27,29,30,36,38,40,41,50], although consistent preferences for flavours that are perceived to be natural, appropriate to the meal, occasion, or culture are found [29,[51][52][53]. ...
... Some consideration for individual preferences, however, is also required; work suggests that not all individuals respond to flavours with increased consump-tion [38,40,41,43,48,49]. Flavour use varies widely in the older population [29], as do flavour preferences [27,29,30,36,38,40,41,50], although consistent preferences for flavours that are perceived to be natural, appropriate to the meal, occasion, or culture are found [29,[51][52][53]. Suggestions to enhance liking for the taste of white meats and white meat dishes may benefit from consideration of foods that are naturally flavoursome, such as lemon, ginger, herbs, and fruits [46,50,54], established flavour combinations, e.g., turkey and cranberry [51][52][53], and the use of self-serving, to allow individuals to accommodate personal preferences [44,45,49]. ...
Older adults may gain health benefits from the consumption of animal-based protein-rich foods, but environmental pressures suggest advocating some meat and dairy foods over others, and understanding the barriers and facilitators for consuming these different foods would be of value. Existing data on the barriers to and facilitators of the consumption of meat and dairy products were re-analysed for differing effects for white, red, and processed meat consumption and for yoghurt, soft cheese, and hard cheese consumption. White meat consumption was associated with fewer concerns over spoilage and waste and stronger perceptions that meat is convenient (smallest Beta = 0.135, p = 0.01), while red and processed meat consumption were positively associated with liking /taste, appearance, and convenience (smallest Beta = 0.117, p = 0.03). Yoghurt and soft cheese consumption were positively associated with liking/taste and medical concerns, and fewer concerns over ability and habit (smallest Beta = −0.111, p = 0.05), while hard cheese consumption was only associated with liking/taste (Beta = 0.153, p = 0.01). Taken together, these data suggest that enhancing or promoting the enjoyment, taste, visual appeal, and ease-of-consumption of the more sustainable meat and dairy options may be of value in encouraging the consumption of these foods in older adults.
... In relation to health, our sample agreed that looking after one's health and consuming a healthy diet were important. A role for healthiness in food choice has been demonstrated previously in older populations [15][16][17]28,42,[57][58][59], and this may be of particular importance for older compared to younger adults, as health may be more of a concern [16,58,60]. Some studies, however, also suggest that health can be of reduced importance, compared to taste, for some older individuals [17,19,22]. ...
... Our findings suggest, firstly, that a focus on taste and enjoyment may be useful. Recommendations that aim to enhance taste and enjoyment have previously been offered [16,23], to include the development of 'foods with richer tastes and strong but appetizing smells' [16,23] and the use of products providing a variety of sensory characteristics [23,34,42]. ...
... Older adults as a population group can also be difficult to reach as many do not consider themselves as old or of special consideration [17,59,74]. Older adults have also been found to reject nutritional advice and nutritional aids as unsuitable for them [29,75,76], resulting in recommendations for 'food first' approaches and the use of familiar foods and practices for improving nutrition and health, where possible [21,32,33,[37][38][39][40]42,50,72,76,77]. Encouraging taste and enjoyment for everyone through the use of natural flavours as a means of complementing existing dishes may suit all requirements. ...
Adding flavours can encourage food intake in older adults for health benefits. The use and attitudes of 22 community-dwelling UK older adults (15 females, aged 65–83 years) towards foods and products that add flavour, e.g., sauces and seasonings, were investigated. Participants used foods/products to add flavour when cooking and eating from 0 to 17 times/day. Taste and flavour were important, and foods/products could add flavour, make foods more pleasant and did not cause discomfort. There were concerns, however, over the healthiness of some foods/products, while consuming a healthy diet and one’s health were important. Reasons for adding flavours largely centred around ‘meal enhancement’, reasons for not adding flavours focused on ‘the product itself’ and ‘characteristics of the meal’, but there was ‘variation’ and many ‘individual differences’. Our findings highlight the benefits of adding flavours for food intakes, particularly the use of naturally flavoursome foods, such as herbs, spices, onion and garlic.
... Food environment, preparation, food intake and enjoyment in the elderly Older adults have declined physiological mechanisms and environmental stimuli that normally regulate and stimulate intake. 151,152 Social environments, economics, time of the day and visual presentation all impact on food intake. 152 A good eating environment is important to stimulate eating in the elderly, and a variety of foods, interaction with others and atmosphere can impact on the enjoyment and stimulation of food intake. ...
... 151,152 Social environments, economics, time of the day and visual presentation all impact on food intake. 152 A good eating environment is important to stimulate eating in the elderly, and a variety of foods, interaction with others and atmosphere can impact on the enjoyment and stimulation of food intake. Various studies provide evidence that a dedicated and enjoyable space at home to consume food will encourage better food intake. ...
... Background music during mealtimes could increase time spent at the dining table and it is documented that older adults use music or the radio for distraction and enjoyment. 151,152 Having access to prepared food has been shown to increase intake in the elderly, 151 but we know that in the SA context a large group of elderly do not live in an environment where prepared food is readily available and that people living at subsistence level often have no choice but to consume monotonous diets. 11 Declining sensory ability and responsiveness impact on the enjoyment of food and therefore a reduced intake. ...
Studies have shown that the elderly are at a higher risk of developing malnutrition due to physiological and pathological changes. Several studies have confirmed that older South Africans have insufficient dietary diversity, resulting in nutritional deficiencies. Furthermore, poor and uninformed dietary choices are associated with the development of several diseases and increased mortality. Following the Elderly Food Based Dietary Guidelines (EFBDGs) related to promoting elderly health could ensure that the elderly have an adequate intake of nutritious foods. This paper provides an overview of six FBDGs relating to promoting health and is based on the South African Food Based Dietary Guidelines.
... For instance, Jaeger et al. (2013) showed that differences in genetic variants determining the sensitivity to β-ionone can alter odour perception and affect choice and acceptance of food products containing βionone. In addition, higher preference and choice for sweet foods was observed in conjunction with olfactory loss due to ageing (Boesveldt et al., 2018;Kremer, Holthuysen, & Boesveldt, 2014). Correspondingly, both human and animal data observed a higher choice for energydense foods with obesity-related olfactory loss (Richardson et al., 2004;Stafford & Whittle, 2015;Thiebaud et al., 2014). ...
... There is little empirical evidence on the relative role of individuals' olfactory and gustatory sensitivities in food choice, however, several olfactory studies have tested the effect of olfactory dysfunction on food choice. For instance, Kremer et al. (2014) investigated the influence of olfactory impairments on eating behaviour and revealed that hyposmic individuals consumed more sweet energy-dense snacks than their normosmic counterparts. In addition, de Vries et al. (2020) showed that the olfactory sense modulates spatial navigation for high-calorie food in different environments. ...
Obesity has become a critical health issue in many developed countries, including New Zealand. While the aetiology of obesity is likely to be multifactorial, overconsumption is deemed as a key behavioural contributor to the growing obesity rate. Emerging sensory nutritional research has proposed that obesity is linked to altered olfactory and gustatory sensitivities, which can in turn influence consumption, particularly of foods rich in sugar, salt, and fats. Despite being promising, empirical studies to test for this hypothesis have returned highly controversial results. The present doctoral thesis aims to ‘systematically evaluate the role of olfaction and gustation in regulating an individual’s adiposity and eating behaviour’, using well-validated psychophysical, nutritional, and food-psychological approach.
The present thesis firstly aimed to develop and test for new approaches to quantify individual chemosensory sensitivities to food-related stimuli, based on assessments of individual performance to decremental (d′(d)) and incremental (d′(i)) stimulus range. Subsequently, these sensitivity measures were analysed against inter-individual differences in adiposity measures and eating behaviour. Additional exploratory research was performed to further analyse possible factors driving chemosensory links to food-related behaviour. Two separate datasets were collected in this thesis, with Data Collection 1 involving N=70 (age range = 21-39 years, BMI range = 20.5-48.1 kg·m-2) and Data Collection 2 involving N=61 (age range = 21-39 years, BMI range = 19.7-41.5 kg·m-2) participants.
The results from the first analysis show that individuals’ sensitivities to decremental stimulus range (d′(d)) and to incremental stimulus range (d′(i)) represent distinct measures. Furthermore, the measure of d′(d) is positively associated with adiposity measures, whereas d′(i) exhibits a negative relationship. Furthermore, these two separate sensitivity measures had significant, but contradictory, relationships with snack intake and total habitual energy intake. Specifically, individuals with poor olfactory and gustatory sensitivities (high d′(d) and low d′(i)) appeared to consume more sweet versus savoury snacks, than their counterparts, pointing to an important differentiating role of snack consumption.
In the context of the aforementioned findings, the last study of the thesis tested whether exposure to olfactory and gustatory cues in a meal influences subsequent snack choice and intake. With a repeated-subject design over one control and four testing sessions, the participants had breakfasts with manipulated olfactory and gustatory characteristics and recorded their snack intake throughout the day. Results from this study revealed that high-intensity olfactory and gustatory characteristics of a meal reduce sweet snack intake and increase the non-sweet snack intake, while total snack intake is maintained across the sessions. Specifically, individuals with high gustatory sensitivity showed more sensory-specific effects compared to the low-sensitivity group. Moreover, the high-BMI group showed sensory-specific effects for low- and high-intensity sweet taste cues, in contrast, the low-BMI group showed sensory-specific effects only for the high-intensity taste cues. Overall, the findings of this specific study highlight that the olfactory and gustatory cues of a meal may have a day-long effect on snack choice, providing novel insights into the observed association between sensory sensitivity and adiposity.
Overall, this doctoral thesis systematically assessed the role of individual olfactory and gustatory sensitivities in influencing adiposity and eating behaviour. With multifactorial data ranging across sensory science, nutrition and food psychology, this thesis provides new insights into inter and intra-individual differences in olfactory and gustatory sensitivities, and their important links to eating behaviour.
... Olfactory impairments can contribute to altered food choices and reduced nutritional intake and status (Duffy et al., 1995, Griep et al., 1995, Kremer et al., 2014, Somekawa et al., 2017. Another flavour compound of interest, which often occurs concurrently with sulfides in dairy foods (Zabbia et al., 2012), is the volatile flavour compound diacetyl (2,3-butandione). ...
... In the current study, the older adult group reported taking almost 8 times higher amounts of daily medication in comparison to the younger group (Table 4-1). Age-related impairments in taste and smell are known to affect older adults ability to Age group determines the acceptability of protein derived off-flavour 152 perceive flavour and have a negative influence on older adults dietary behaviour, nutritional intake and nutritional status (Duffy et al., 1995, Griep et al., 1995, Kremer et al., 2014, Somekawa et al., 2017. Agerelated sensory impairments are often debilitating. ...
Within the increasing older population, there is a burden of undernutrition. The prescription of oral nutritional supplements (ONS) for those who are undernourished, or at risk of undernutrition, can help improve nutritional status, but the patient must consume an adequate quantity of ONS to gain the clinical benefits. This research first reviewed the literature to identify factors that influence adherence to ONS. Good palatability is crucial for adequate intake of ONS, but palatability challenges stem from both the product (undesirable sensory properties) and the consumer (age-related sensory changes). The contribution made by aroma compounds to the palatability of ONS was recognised as a comparatively underresearched area. Therefore, this work aimed to fill the evidence gap by investigating the role of intrinsic flavour quality (with emphasis on aroma) and age-related changes in oronasal physiology and sensory abilities on sensory perception and palatability of ONS. The characterisation of aroma-active compounds in a commonly prescribed ONS was a fundamental stage in the research. Esters (sweet, fruity) and diacetyl (sweet, buttery) were found to make a large contribution to the perceived flavour of the studied ONS. Sulfurous aroma compounds, likely stemming from the heat-treatment of protein ingredients, were also found to contribute to the perceived flavour of ONS. An orthonasal hedonic evaluation established that sulfurous aroma compounds are primarily unpleasant, whereas the fruity ester aroma (isoamyl acetate) and diacetyl are primarily pleasant. However, sulfurous aromas were rated more pleasantly by older adults who also had impairments in their ability to detect aromas at threshold concentrations. When aromas were combined in a mixture within a real-food matrix (a flavoured dairy beverage), sulfurous aroma compounds were shown to negatively impact consumer acceptance (for consumers aged 18 – 79 years). However, these sulfurous flavours were less objectionable for older adults. This is a novel finding because it suggests that olfactory impairments may benefit older consumers who need to consume protein-rich foods containing off-flavours. Furthermore, the addition of diacetyl increased the acceptability of the sulfurous flavours, demonstrating partial masking abilities of this compound. Older adults are also known to experience age-related changes in their oral and nasal physiology, such as reduced salivary flow rates which may influence the way flavours are released in the mouth. Therefore, the next stage of the research investigated differences in the temporal consumption experience (comprising in-mouth aroma release, sensory perception and subjective appetite) of a clinically relevant portion of ONS for groups differing in saliva flow rate, in which repeated measurements were made between sips. This study demonstrated that a lower saliva flow rate is associated with significantly more intense in-mouth aroma release (p=0.015), significantly higher aftertaste intensity (p<0.001), and greater increase in mouth drying over sips (p=0.02), compared to a medium- and high- saliva flow rate. These findings occurred concurrently with relatively lower hunger sensations in the low- and medium-flow rate groups. This research adds to the growing body of evidence on how best to optimise food and beverage palatability for older consumers. Many older patients who are prescribed ONS are likely to experience reduced salivary flow rates and olfactory impairments. The unique sensory experience of these individuals should be considered in both product development and clinical practice to optimise palatability, hence maximising nutritional intake from ONS and other nutritional foods and beverages whilst minimising wastage.
... The effect of this type of information is welldocumented yet conflicting in literature. It has only been used once specifically with older adults to study the effects of information regarding salt reduction on liking of meatballs and protein-enhancement on bread [24]. Liking scores for these products increased after receiving information about their positive nutritional changes [24]. ...
... It has only been used once specifically with older adults to study the effects of information regarding salt reduction on liking of meatballs and protein-enhancement on bread [24]. Liking scores for these products increased after receiving information about their positive nutritional changes [24]. ...
Older adults (60+ years) are at higher risk of malnutrition. Improving the nutrient-density of their diets is important but presents challenges due to the introduction of new ingredients, liking implications and heterogeneity of older consumers. Ten nutrient-enhanced foods were evaluated for liking (9-point hedonic scale) and sensory perception (check-all-that-apply) by 71 older adults. Three foods were re-evaluated after participants were provided with information about their healthy ingredients and benefits. Participants were also segmented based on their degrees of food neophobia and interests in healthy eating, using questionnaires. The results showed that eight foods had adequate sensory appeal (overall hedonic score of 6) to be pursued for residential care menus. Segmentation based on food neophobia and healthy eating interests did not yield any meaningful differences between groups. The effect of health information on liking for the overall sample and subgroups was product-specific: liking scores only increased for the raspberry banana smoothie in the overall test population and higher healthy eating interest subgroup. Health information may lead to the experience of more positive attributes in some foods. Overall, eight foods that were tested could be accepted by a wide range of consumers and providing them with health information may further improve acceptance.
... Conversely, a priori segmentation of consumer based on the same criteria (i.e. age, ethnicity) is suggested for the hedonic evaluation of food products, as different degrees of familiarity with the product across such consumer groups can determine large differences in perceived liking (Hong et al., 2014;Kremer et al., 2014;Pagès et al., 2007). ...
... Recent studies have shown a positive relation between physical textural complexity and satiation, which appears to be independent of oral processing time Marcano et al., 2015;Tang et al., 2016;Tarrega et al., 2016). Since the presence of multiple components in a food product is expected to postpone sensory-specific satiety (SSS) (González et al., 2018;Guinard & Brun, 1998;Weijzen et al., 2008;Wilkinson & Brunstrom, 2016) by combining textural and flavour complexity (Kremer et al., 2014), food intake and satiation of consumers could be controlled, while ensuring an equal or enhanced palatability of the product. ...
Background and aim: Many foods consumed daily are composed of multiple elements which often display a heterogeneous structure, flavour, and appearance. These heterogeneous food products are generally well-liked by consumers, although little information is available about the key factors responsible for their appreciation. This thesis aims to determine how food and consumer characteristics affect sensory perception and liking of heterogeneous foods by engineering structural heterogeneities at different length scales. The effects of structural heterogeneity on expected and perceived sensory properties and liking of foods were investigated considering different consumer groups.
Methods: A combination of model and real food products were used to establish the effect of physical and physicochemical properties of heterogeneous food matrices on sensory perception and liking in relation to consumer expectations and physiological characteristics. Instrumental characterization of the products was related to the sensory perception, studied through a variety of methods (e.g. R.A.T.A., Ideal Profile, TDS). Consumer groups differing in age (i.e. healthy young adults vs. healthy elderly) or nationality/ethnicity (i.e. Dutch, Caucasian vs Chinese, Asian) were used to explore the generalisability of the effects.
Results and conclusions: This thesis showed that variations in mechanical properties (e.g. fracture stress) between the components are the main driver of perceived heterogeneity by the consumer. For particle-filled foods, oral perception of the product can be influenced by varying both the size and the hardness of added particles, independently from the matrix consistency. Visual recognition of particle as a function of type, size, and concentration can stir expected sensory profile and liking of familiar and novel food products, although the palatability of the food depends on the particle properties. It was demonstrated that consumers prefer the presence of soft and easy-to-chew particles and that the mere mechanical contrast between components does not increase liking of foods. Conversely, this work revealed that congruent and familiar particles that match consumers’ expectations are required to boost palatability of heterogeneous products. Overall, such outcomes appear to be valid for a large spectrum of the population as relative small differences in perception of heterogeneous foods were observed between groups of healthy consumers (young vs elderly; Dutch vs Chinese). Moreover, the combination of different textures by addition of particles was proved to be an effective strategy to compensate for undesired textural sensations (e.g. grittiness) and to control oral consumption time with possible positive consequences for food intake.
... Conversely, a priori segmentation of consumer based on the same criteria (i.e. age, ethnicity) is suggested for the hedonic evaluation of food products, as different degrees of familiarity with the product across such consumer groups can determine large differences in perceived liking (Hong et al., 2014;Kremer et al., 2014;Pagès et al., 2007). ...
... Recent studies have shown a positive relation between physical textural complexity and satiation, which appears to be independent of oral processing time Marcano et al., 2015;Tang et al., 2016;Tarrega et al., 2016). Since the presence of multiple components in a food product is expected to postpone sensory-specific satiety (SSS) (González et al., 2018;Guinard & Brun, 1998;Weijzen et al., 2008;Wilkinson & Brunstrom, 2016) by combining textural and flavour complexity (Kremer et al., 2014), food intake and satiation of consumers could be controlled, while ensuring an equal or enhanced palatability of the product. ...
This study investigated whether the addition of macroparticles or fat can be used to compensate for negative texture sensations in quark. Cellulose beads were added as model microparticles (1.5% w/w; average size: 263 µm) to quark (0% fat) to induce unpleasant gritty sensations. The addition of microparticles to quark significantly increased grittiness and dryness, while creaminess and liking decreased. Three strategies were explored to reduce the impact of unpleasant gritty sensations on consumer perception: two strategies involved the addition of macroparticles (granola or peach gel pieces); the third one consisted of increasing the fat content of the quark (4.4 and 8.8% w/w). For all three strategies, grittiness caused by microparticles did not significantly decrease when macroparticles or fat were present. Addition of peach gel pieces to quark with microparticles did not increase liking. When granola pieces were added to quark containing microparticles, liking increased significantly despite that grittiness was still perceived. Temporal Dominance of Sensations (TDS) revealed that addition of granola pieces caused prolonged dominance of positive, crunchy sensations and minimized dominance of negative, gritty sensations. The addition of fat did not lead to a significant increase in liking of quark, although when a medium amount of fat was added (4.4%), it also did not decrease liking significantly. This was probably due to an effective hedonic compensation triggered by more positive sensations (i.e. sweetness). We conclude that addition of crunchy granola pieces or fat can be used as strategies to shift and increase dominance of positive and liked attributes, leading to an increase of overall liking, although negative sensations (grittiness) caused by microparticles are still perceived. This approach could be used to compensate for undesired texture sensations in different types of foods, such as high protein foods.
... En parallèle de ces travaux, certains auteurs ont observé qu'une baisse des capacités chimiosensorielles pouvait s'accompagner d'une baisse d'appétit (de Jong et al., 1999), d'une baisse d'intérêt pour les activités culinaires (Duffy et al., 1995) ou d'une baisse de la variété alimentaire (Kremer et al., 2014). ...
... Ce travail a également montré que les prototypes améliorés sur l'ensemble des caractéristiques sensorielles du produit (saveur, arôme, texture) étaient préférés aux prototypes améliorés uniquement sur la flaveur. Ceci plaide clairement en faveur d'une approche multidimensionnelle dans le développement de produits alimentaires à destination des personnes âgées (voir aussi Forde et Delahunty, 2004 ;Kremer et al., 2014) 2. Adapter la texture des aliments à la santé orale des personnes âgées ...
Le vieillissement s’accompagne fréquemment d’une baisse de l’appétit et de la prise alimentaire, ce quiprédispose la personne âgée à une perte de poids et augmente le risque de dénutrition. Des travauxrécents ont montré que moins de 10% des personnes âgées en maison de retraite satisfont à leursbesoins caloriques et protéiques, tandis que 37% consomment moins de 2/3 des Apports ProtéiquesConseillés. Face à l’enjeu considérable que représente la dénutrition en matière de qualité de vie et desanté publique, il est essentiel de développer une offre alimentaire répondant aux besoins nutritionnelsdes seniors, tout en satisfaisant leurs préférences et leurs capacités préservées. L’objectif de cetterevue est de présenter un état des lieux et des perspectives concernant le développement d’alimentsadaptés (i) aux préférences sensorielles et (ii) aux capacités orales des personnes âgées.
... The fermentation-produced substances can be beneficial for consumers, who benefit from increased health-promoting properties. Aging-related changes in metabolism, anatomy, and sensory perception impact a person's ability to chew and swallow, as well as their digestive system, appetite, perception of taste and smell, metabolism, and ability to absorb nutrients (Kremer et al., 2014). Fermentation offers an acidic environment that can lower the pH of meat, leading to an improvement in meat tenderness through proteolysis (Fadda et al., 2010), which can offer easier chewing and swallowing for consumers as well as the elderly. ...
The physicochemical properties and sensory evaluation of goat meat-fermented sausages were investigated by incorporating different concentrations of pineapple and fig powders (0.1, 0.25, and 0.5%). During processing, moisture, pH, and lightness decreased, whereas fat content, antioxidant activity, and redness increased. When pineapple and fig powders were added, the moisture, antioxidant activity, lightness, protein degradation, and tenderness of the sausages increased. As the incorporation of pineapple and fig powders increased, the pH, fat, redness, protein, total plate count, metmyoglobin, and residual nitrite content of the sausages decreased. In particular, the addition of 0.5% pineapple powder strongly decreased the pH, total plate count, metmyoglobin, and residual nitrite content, and increased protein degradation. The inclusion of 0.5% fig powder significantly decreased fat content and increased tenderness. In addition, 0.1% pineapple and 0.25% fig powder-treated sausages indicated good nutritional indices in the fatty acid profile. However, the incorporation of 0.5% pineapple and 0.25% fig powders resulted in the highest overall acceptance rates. Based on these investigations, pineapple and fig powder-treated goat meat fermented sausages could fulfil the nutritional requirements of the elderly as well as consumers due to tenderness, protein degradation, and high nutritional index.
Keywords: fermented sausage; goat meat; pineapple; fig; protein degradation
... Additionally, OD negatively affects social food-related activities, such as going out for dinner [4,29]. The literature suggests a few strategies to cope with the diminished perception of flavor, such as eating with family and friends, adding spices to stimulate trigeminal sensations (i.e., tingling or burning feeling), and focusing on the texture, temperature, and visual presentation of the food [17,16]. Recent experiments suggest that personalized foods tailored to meet individual users' unique needs and preferences could serve as an effective intervention for individuals with OD of various etiologies [1]. ...
Olfactory dysfunction is a complication arising from various factors, including neurodegenerative disorders, aging, and viral infections like COVID-19. It can adversely affect appetite and food enjoyment, potentially leading to malnutrition. Food tailored to the sensory preferences of such patients can be an effective intervention. However, the utilization of artificial intelligence for suggesting suitable food and persuasive designs for presenting such suggestions has yet to be researched in this context. To address this gap, we conducted a co-creation workshop with patients and multidisciplinary experts to identify food-related goals and challenges faced in daily contexts. The emerging solutions are personalized food recommendations, flavor enhancements, and food sensory descriptors. However, the current databases and models are not suitable for producing these solutions. This is due to the complex feature set required to produce such recommendations. Moreover, such a system needs to incorporate factors such as health, enjoyment, and practical limitations to provide adequate support. Therefore, we outline a research roadmap toward providing personalized and persuasive artificial intelligence for people with olfactory dysfunction.
... Strengthening flavors in TMF may be advantageous to improving food perception in older adults since doing so may enhance palatability, increase salivary flow, and help maintain food, calory, and nutrient intake while allowing people to retain the joy of eating and engaging positively with food (Susan S. Schiffman, 2000). Research results on the effect of flavor enhancement on liking, appetite, and food intake, however, are contradictory (Griep et al., 1997;Kremer et al., 2007Kremer et al., , 2014S. S. Schiffman & Graham, 2000;Thomas et al., 2021;White et al., 2020). ...
Acceptance of texture‐modified meals in healthy older adults with pre‐clinical symptoms of dysphagia may facilitate gradually transitioning to a soft diet. Little is known about the sensory attractiveness of such meals in home living older adults. This study aimed to examine liking among a group of healthy, independent older adults for texture modified chicken breasts and gravy. A secondary aim was to evaluate liking in relation to olfactory‐ and taste function. Texture‐modified chicken breasts were prepared to appear identical to the unmodified chicken breasts. This is a new approach which aims to improve visual appearance of the meal compared to existing texture‐modified meals. Ordinary chicken breasts obtained significantly higher liking scores across all sensory parameters compared to the texture‐modified products. Texture modified chicken breasts need further adjustment for a broad acceptance. Adding flavor‐enhanced gravy did not change the liking pattern. This study supports the notion that texture plays a central role for meal acceptance.
Practical Applications
Healthy older adults find the modified texture of chicken breasts acceptable. The unique technique applied to modify the texture uses fresh ingredients while offering improved flavor and appearance, which increases the acceptability of meals in a social context. These meals represent an acceptable alternative for older adults in a preclinical state of dysphagia who require meals comparable to unmodified chicken breasts.
... The elderly with olfactory dysfunction were reported to need much more time to sniff and taste for completing sensory evaluation and they scored lower on the overall odor intensity of food compared with those with normal olfactory (Flaherty and Lim, 2017;Arikawa et al., 2020). The decreased chemosensory functions were related to the loss of appetite or the tendency to flavor-reenforced food, such as sugar or salt fortified foods (Laureati et al., 2008;Schwartz et al., 2018), as well as lower interest in salt-reduced meatballs (Kremer et al., 2014). However, it was also found that loss of chemical sensory did not necessarily lead to the preference for flavor enhanced foods (Baugreet et al., 2017). ...
Background
The impairments of physiological functions caused by aging are common problems in the elderly, especially the impairments of sensory perception. Besides, close relationship between food sensory perception and nutritional status also suggests the importance of dietary management for the elderly population. The foods taking sensory perception into account are urgently needed by the elderly.
Scope and approach
This review analyzed sensory perception changes and their effects on food behaviors and nutritional status. Besides, sensory properties essential for aged-foods and acquisition methods, as well as current status of such foods were summarized.
Key findings and conclusions
Soft, smooth and moisty foods were more suitable for the elderly with chewing and swallowing dysfunction, which can be prepared by gelation, enzyme treatment, blade tenderization and other non-thermal technologies. Flavor enhancement/enrichment, irritant addition and packet sauces were recommended to compensate the impairment of chemical sensory. Molds, piping bag and 3D printing were suggested for refining appearance of pureed foods, and improving appetite of the elderly.
... This change impacts the meal experience (Pützer & Wolf, 2021) because resistance to food intake is motivated more heavily by disliking than liking (Keller et al., 2022). Despite the lack of evidence on the influence of chemosensory changes on declining food intake, appetite and malnutrition (Kremer et al., 2014;Rolls, 1999) and changes in familiarity and identification ability may lead to changes in food intake and appetite because they co-occur with other age-related events that affect the context and meal experience (Nyberg et al., 2018;Sulmont-Rossé et al., 2015). This, in turn, may lead to weight loss and malnutrition over time, or what is also known as the anorexia of aging (Landi et al., 2016), which can enormously influence health and quality of life (Doty et al., 1984;Hedner et al., 2010;Larsson et al., 2005;Larsson & Bäckman, 1997;Olofsson et al., 2016;Sohrabi et al., 2012;Stevens et al. 1990;Wehling et al., 2016). ...
In an aging population, changes in sensory abilities can adversely affect enjoyment of a meal. Age-related changes in identification ability and familiarity of food odors may influence food intake since some foods become less recognizable and attractive, which may affect the individual’s health and nutritional condition. The aim of this study was to examine age-related changes in familiarity and the ability to correctly identify everyday food odors in older adults. We also aimed to establish the relationship between these changes and hedonic liking of food odors compared to young adults. The study included 335 participants, 246 older adults and 89 young adults. A positive relationship between familiarity and liking was observed across all food odors. Familiarity and odor identification ability declined with increasing age. The most significant loss in the ability to identify odors was observed for curry, fried meat, and toasted bread, while both age groups identified banana, orange, and vanilla equally well. For older adults with a diminished perception of familiarity and a reduced ability to identify odors correctly, increasing the concentration of the odor improved familiarity and enhanced their ability to identify odors. Our findings support the notion that the familiarity of food odors is an important parameter for the appreciation of food in older adults.
... Therefore, a multisensory enrichment approach across different modalities may be useful for increasing food pleasure in seniors both with and without olfactory or taste impairment (Song et al., 2016). It has been shown that older people, regardless of their olfactory status, respond positively to multisensory enrichment in foods (Kremer et al., 2014). Another study showed that the improved overall sensory features (texture, taste, and aroma) were more preferred over the solely enhanced flavor (Sulmont-Ross é et al., 2018). ...
Odor-induced taste enhancement (OITE) is a phenomenon derived from the integrative processing of odor and taste in the brain. In summarizing the published research articles on OITE, the current review discusses the effects of odor concentration, odor perceptual routes (orthonasal or retronasal), and the odor-taste congruency on OITE. In addition, the review highlights the neural mechanisms of OITE by presenting human neuroimaging research results related to the brain processing of taste intensity, taste quality of odors, and taste-odor interactions. Finally, the paper discusses the implication of OITE on nutritional and clinical applications. The identification of odor molecules with potent taste enhancement effects and the application of OITE in the food industry and clinical populations are necessary for future research.
... A more recent study, using longitudinal data, strengthens the associations by showing that olfactory impairment in aging persons, at least among women, might be a contributing factor to poor diet quality (Gopinath et al., 2016). Furthermore, B. J. Rolls and McDermott (1991) demonstrated diminished sensory-specific satiety in old age, which may contribute to the decreased dietary variation with age, and Kremer et al. (2014) showed that those with diminished olfaction more often report eating the same meal within a week. However, not all studies have shown an association between chemosensory impairment and nutritional problems (e.g., Toussaint et al., 2015), and lack of sensory feedback from eating may in some cases actually lead the individual to eat more, increasing risk for obesity. ...
Olfaction, the sense of smell, is characterized by a notable age-dependency such that aging individuals are more likely to have poor olfactory abilities. These impairments are considered to be mostly irreversible and as having potentially profound effects on quality of life and food behavior, as well as constituting warning signs of mortality, cognitive dysfunction, and dementia. Here, we review the current state of research on aging and olfaction, focusing on five topics which we regard to be of particular relevance for the field: nutrition and health, cognition and dementia, mortality, environment and genetics, and training-based enhancement. Under each of these headlines, we provide a state-of-the-art overview and discuss gaps in our knowledge which might be filled by further research. Understanding how olfactory abilities are diminished in aging, and how they may be alleviated or recovered, involves a set of challenging tasks for researchers in the years to come.
... Studies that describe a decline in chemosensory capacities with aging typically also report a large degree of inter-individual variability (Methven, Allen, Withers & Gosney, 2012;Sulmont, Maitre et al., 2015). Likewise, although a decrease in chemosensory capacities has been proposed to be a risk factor for anorexia and malnutrition in the older people (Rolls, 1999;Hays & Roberts, 2006), overall, evidence from the literature is far from conclusive (Duffy, Backstrand & Ferris, 1995;Griep et al., 1996;de Jong, Mulder, De Graaf, & van Staveren, 1999;Kremer, Holthuysen & Boesveldt, 2014; Fluitmanet al., 2019; Arikawa et al., 2020; Grinberg, de Mello Franco, Pinto-e-Silva, Matos, 2020). As an example, Griep et al. (1996) found significant link between olfactory perception and intake for energy but not for proteins in older women. ...
The aging process is associated with physiological, sensory, psychological, and sociological changes likely to have an impact on food intake and the nutritional status. The present study aimed to explore the heterogeneity of the French older population (>65 years old) using a multidisciplinary approach. More specifically, the study aimed to highlight different typologies (i.e. clusters of individuals with similar characteristics) within the older population. We conducted face-to-face interviews and tests with 559 French older people, recruited from different categories of dependency (at home without help, at home with help, in nursing homes). Clustering analysis highlighted seven clusters. Clusters 1-3 contained ‘young’ older people (<80) with a good nutritional status; these clusters differed according to food preferences, the desire to have a healthy diet, or interest in food. Clusters 4-7 mainly contained ‘old’ older people (80+), with an increase in the nutritional risk from cluster 4 to cluster 7. Two of these clusters grouped healthy and active people with a good level of appetite, while the two other clusters were associated with a clear decline in nutritional status, with people suffering from eating difficulties or depression. The results raise the need to develop targeted interventions to tackle malnutrition and implement health promotion strategies among the seniors.
... However, Arganini and Sinesio [16] hypothesised that the role of chemosensory impairment (taste and smell impairment) in diminished eating pleasure and appetite is overestimated, and that psychosocial factors such as loneliness, dietary restrictions, perceived taste impairment and subjective health status significantly influence the decline of eating pleasure in older people. This hypothesis is also supported by other studies reporting the limited influence of taste and smell impairments on food liking or intake [40,41]. These findings indicate that psychosocial factors related to altered dietary habits should not be overlooked by health professionals. ...
(1) Background: Ageing is associated with a decline in sensory function (sight, hearing, taste, touch and smell), which play an important role in the maintenance of an older person’s health, independence and well-being. (2) Methods: This qualitative study obtained data through face-to-face semi-structured interviews with a convenience sample of thirteen community-dwelling adults 65 years and older. Themes were derived inductively, guided by semi-structured interviews. (3) Results: Twelve participants had two or more sensory impairments, mainly concurrent hearing and vision, which became apparent when a situation/individual alerted them to change/s occurring. They were less aware of impaired smell, taste and touch. Sensory changes impacted on important life functions, prompting many participants to take measured risks in maintaining their independence. Half (seven) of the participants lacked motivation to manage sensory function through goal-directed behaviour, taking remedial actions only when this was relevant to lifestyle preferences. (4) Conclusions: Internal and/or external triggers of sensory changes did not generally motivate remedial action. Health professionals can help to improve older people’s attention to sensory impairment by routinely discussing sensory function with them, screening for sensory changes and facilitating early intervention and support.
... Regarding health-related quality of life (HRQoL) , the lack of physical fitness is a reliable predictor of negative physical and psychological health consequences (Ikezoe, Asakawa, Shima, Kishibuchi and Ichihashi, 2013). Therefore, the aging phenomenon needs to be addressed using suitable strategies that maintain the HRQoL and health of elderly people for as long as possible (Kremer, Holthuysen and Boesveldt, 2014). ...
During a specific time of life, aging is a natural and inevitable process which affects the decline of cognitive capacity and psychological disorders. However, a lot of people do not manage a correct quality of life due to physical fitness or psychological variables such as anxiety and depression. The aim of the present study is to analyze the relationship of anxiety and depression with quality of life related to health and physical fitness level in middle-age women. A total of 116 women aged between 41 and 79 years participated in this study. A cross-sectional study was used to assess clinical characteristics, anxiety and depression variables, health-related quality of life and physical fitness of participants. The results indicated that high levels of depression were not presented. However, higher HADS-anxiety and HADS-depression status groups showed the worst physical fitness test except thelower body muscular strength. It is necessary to highlight the relevance of engagement in physical-educative programs to decrease levels of depression and anxiety, improving subjects' quality of life related to health and physical fitness in middle-age women.
... Moreover, patients with smell loss typically do not have lower energy intake or present with low BMI (Mattes et al. 1990;de Jong et al. 1999;Duffy et al. 1995). In addition, research has shown no relation between (loss of) olfactory function and liking of (flavor-enhanced) foods (Kremer et al. 2007(Kremer et al. , 2014Koskinen et al. 2003;Boesveldt et al. 2018). Thus, although there may not be a direct relation between olfactory function and nutritional status (Toussaint et al. 2015), smell loss mostly affects the pleasure in food behavior. ...
The human sense of smell is still much underappreciated, despite its importance for vital functions such as warning and protection from environmental hazards, eating behavior and nutrition, and social communication. We here approach olfaction as a sense of well-being and review the available literature on how the sense of smell contributes to building and maintaining well-being through supporting nutrition and social relationships. Humans seem to be able to extract nutritional information from olfactory food cues, which can trigger specific appetite and direct food choice, but may not always impact actual intake behavior. Beyond food enjoyment, as part of quality of life, smell has the ability to transfer and regulate emotional conditions, and thus impacts social relationships, at various stages across life (e.g., prenatal and postnatal, during puberty, for partner selection and in sickness). A better understanding of how olfactory information is processed and employed for these functions so vital for well-being may be used to reduce potential negative consequences.
... A more recent study, using longitudinal data, strengthens the associations by showing that olfactory impairment in aging persons, at least among women, might be a contributing factor to poor diet quality (Gopinath et al., 2016). Furthermore, B. J. Rolls and McDermott (1991) demonstrated diminished sensory-specific satiety in old age, which may contribute to the decreased dietary variation with age, and Kremer et al. (2014) showed that those with diminished olfaction more often report eating the same meal within a week. However, not all studies have shown an association between chemosensory impairment and nutritional problems (e.g., Toussaint et al., 2015), and lack of sensory feedback from eating may in some cases actually lead the individual to eat more, increasing risk for obesity. ...
Olfaction, the sense of smell, is characterized by a notable age-dependency such that older individuals are more likely to have poor olfactory abilities. These impairments are considered to be mostly irreversible and as having potentially profound effects on quality of life and food behavior, as well as constituting warning signs of mortality, cognitive dysfunction and dementia. Here, we review the current state of research on aging and olfaction, focusing on five topics which we regard to be of particular relevance for the field: nutrition and health; cognition and dementia, mortality; environment and genetics; training-based enhancement. Under each of these headlines, we provide a state-of-the-art overview and discuss gaps in our knowledge which might be filled by further research. Understanding how olfactory abilities are diminished in old age, and how they may be alleviated or recovered, presents a set of challenging tasks for researchers in the years to come.
... Furthermore, the combined effect of extra cream and parsley topping on energy intake, weighted intake, overall liking and emotional response towards maize soup were investigated, the result shown a synergistic effect, which was supported by the studies of Maître, Symoneaux, Issanchou, De Facq, Tavarès, Feyen, and Sulmont-Rossé (2014) and Kremer, Holthuysen, and Boesveldt (2014). In their works, Fig. 6. ...
The objective of this study was to investigate the effects of enriched energy density and visual topping on maize soup’s intake, overall liking, taste liking, food-evoked emotion and perceived familiarity among older home-dwelling people. This study consisted of two tests: in the first test, the most appetising soup was chosen from six high-energy soups topped with different condiments by testing participants’ rankings based only on appearance; while in the second test, participants tasted the most visually appealing maize soup (high-energy maize soup topped with parsley), as well as topping-free high-energy maize soup and low-energy maize soup. Enriched energy density significantly increased the energy intake of maize soup, and visual topping significantly increased both the weighed intake and energy intake of high-energy maize soup. A combined sensory dimension modification of maize soup by enriching energy density and adding visual topping positively affected weighed intake, energy intake, overall liking and food-evoked emotion of maize soup. Slight changes of meal appearance by adding visually appetising toppings could be an effective method to encourage older consumers’ food consumption. In addition, combined sensory enhancement for food could have synergetic effect on older people’s food consumption and eating experience.
... However, aging is often accompanied by changes in food consumption, either voluntary or more often due health issues [11], by isolation and depression or by alterations in sensory sensitivity [12], which affect taste and smell and food choices [13]. This may lead to disaffection for eating and inappropriate food behaviors that may lead to malnutrition, accelerating the aging process and increasing the risk of disease and mortality [14]. ...
Cardiovascular diseases (CVD) are the leading cause of mortality. However, by treating modifiable cardiovascular risk factors and following a healthy diet as the Mediterranean diet, we have opportunity to prevent CVD. In the EWHETA (Eat Well for a HEalthy Third Age) Project, our goal has been to develop novel foods (“Mediterranean Lasagne”, MLs) in versions all nutritionally complete and well balanced in terms of calories, whole carbohydrates, fibers, source of vegetable proteins, and vegetable fats. MLs can be easy prepared at home (inexpensively) and used as fresh food or can be pre-prepared and used in residences for elderly people or in health care residencies. The project has saw the alliance between nutritionists and food and sensor scientists and the active involvement of older people in tasting the novel foods to achieve the final tasty versions of the MLs. We think that the nutritional components of these novel foods and its well-accepted taste, insert in a healthy diet and life style (fundamental aspects at every age), and could contribute to improve diet in the elderly people and prevent malnutrition.
... Sensory education has been advocated in children with increasing willingness to eat healthier and to try novel foods [42,43]. In elderly reduced olfactory function can lead to a monotonous diet [44]. At the same time OT can be applied in elderly and improve quality of life [45]. ...
PurposeOlfactory training is recommended in olfactory dysfunction (OD) showing promising results. OD patients frequently ask for training modifications in the hope of a better outcome. Also, a lack of knowledge of the flavor system is evident. This investigation sought to implement flavor education (FE) and encourage patients to experience flavors in terms of a flavor training (FT).Methods
In included patients (n = 30), OD was either of postinfectious (86.7%) or posttraumatic (13.3%) cause. Chemosensory abilities were tested orthonasally (using Sniffin Sticks = TDI) and retronasally (using the Candy Smell Test = CST). Key points of flavor perception were demonstrated in an educative session. Subjects were instructed to consciously experience flavors out of a list of 50. Effects of FT were explored in two groups (group A and B), with group B starting FT 17 weeks later.ResultsFE was appreciated and drop-out rate stayed very low (one participant). Compliance was high and 30.4 ± 12.9 flavors were tried. Overall TDI scores improved in 10 patients (6 group A, 4 group B) in a clinically significant way (> 5.5). For group A (starting FT earlier) rm-ANOVA showed a significant effect of session (timepoint) on CST (p < 0.01).Conclusion
Flavor education is demonstrated as feasible and appreciated in a clinical setting. FT seems to be a welcomed second-line therapy in patients with olfactory dysfunction. This study shows beneficial trends of FT; however, further studies with larger sample sizes and standardized training protocols are needed.
... Además, los mismos autores constataron los beneficios citados anteriormente a través de un ejercicio físico controlado, justificando un hecho real que se manifiesta cada vez más y que es tratado desde una perspectiva multidisciplinar mediante estrategias saludables. Todo ello, sin que el principal objetivo a medio y largo plazo sea la prolongación de la vida, sino el mantenimiento y mejora de calidad de esta (Kremer, Holthuysen y Boesveldt, 2014). Entonces, se hará necesaria una correcta aplicación de ApS entre estudiantes universitarios y personas mayores. ...
Enrique RIVERA-GARCÍA (Universidad de Granada-España) RESUMEN La sociedad actual demanda cada vez más una participación ciudadana con carácter social hacia colectivos en riesgo de exclusión social. La universidad, apelando a su responsabilidad social en el ámbito docente, debería facilitar dicha participación y fomentar en el alumnado la transmisión de valores tanto éticos como de concienciación hacia los demás. Un método pedagógico útil para cristalizar este compromiso firme con determinados colectivos que realmente lo necesitan es el «aprendizaje-servicio» (en adelante ApS). En este contexto, el presente estudio justifica la idoneidad y viabilidad de desarrollar proyectos de ApS con el colectivo de personas mayores dentro de los grados universitarios del campo de la Educación Física y el Deporte. En particular, se defiende la posibilidad de ayudar eficazmente al sector poblacional de las personas mayores en el ámbito de la salud, favoreciendo la formación en valores del alumnado desde un enfoque pedagógico práctico, competencial y motivador. En particular, se defiende que el diseño y desarrollo de proyectos en torno al ejercicio físico y la salud dirigidos a grupos de personas mayores constituye una estrategia motivante, innovadora y práctica para sensibilizar y concienciar al alumnado ante estos problemas y promover valores educativos. ABSTRACT Current society demands increasing citizen participation to assist at-risk groups of social exclusion. Calling upon the social responsibility of the teaching profession, university should encourage the transmission of awareness-raising ethical values to university students. A useful pedagogical method to foster such commitment with needy groups is the «service-learning» approach. In these context, this paper justifies the suitability and feasibility of developing service-learning projects with elderly 1 Correspondencia en relación con este artículo: pedrojesus.ruiz@unir.net
... Detecting and identifying a smell or taste plays an important role in liking of food products, but also has a functional role (e.g., to signal spoiled food or nutrient content) [5]. With aging, a decrease in olfactory and gustatory function may change food preferences and thereby dietary patterns [6][7][8][9][10]. Furthermore, poor olfactory function is associated with higher mortality in older adults [11]. ...
Our aim is to compare olfactory and gustatory function and food preferences of patients with Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD) with controls. We included 22 patients with MCI, 30 patients with AD and 40 controls and assessed olfactory threshold, odor discrimination and odor identification (Sniffin’ Sticks), gustatory functioning (Taste Strips), and food preferences (Macronutrient and Taste Preference Ranking Task). Linear regression analyses were used to study associations of five cognitive domains or AD biomarkers with olfactory functioning. Groups did not differ in olfactory threshold, gustatory function and food preferences. Patients with MCI and AD scored lower on odor discrimination and identification than controls. Poorer memory, but no other cognitive domain, was associated with poorer odor discrimination and odor identification, but not with odor threshold. No associations with AD biomarkers were found. In conclusion, patients with MCI and AD have poorer odor discrimination and identification ability than controls, but similar detection thresholds. This is likely a consequence of poorer memory rather than directly caused by AD pathology.
... Study participants were recruited from the SenTo panel, a consumer panel of Wageningen University and Research, consisting of > 800 seniors, as described elsewhere [33]. SenTo members aged 60 years and over received an invitation for study participation. ...
The aim of this explorative study is to evaluate whether personalized compared to generic lifestyle advice improves wellbeing in a senior population. We conducted a nine-week single-blind randomized controlled trial including 59 participants (age 67.7 ± 4.8 years) from Wageningen and its surrounding areas in the Netherlands. Three times during the intervention period, participants received either personalized advice (PA), or generic advice (GA) to improve lifestyle behavior. Personalization was based on metabolic health measures and dietary intake resulting in an advice that highlighted food groups and physical activity types for which behavior change was most urgent. Before and after the intervention period self-perceived health was evaluated as parameter of wellbeing using a self-perceived health score (single-item) and two questionnaires (Vita-16 and Short Form-12). Additionally, anthropometry and physical functioning (short physical performance battery, SPPB) were assessed.
Overall scores for self-perceived health did not change over time in any group. Resilience and motivation (Vita-16) slightly improved only in the PA group, whilst mental health (SF-12) and energy (Vita-16) showed slight improvement only in the GA group. SPPB scores improved over time in both the PA and GA group. PA participants also showed a reduction in body fat percentage and hip circumference, whereas these parameters increased in the GA group Our findings suggest that although no clear effects on wellbeing were found, still, at least on the short term, personalized advice may evoke health benefits in a population of seniors as compared to generic advice.
... It is a trivial experience how the taste of food changes when we have a cold, thus providing anecdotal support for the importance of olfactory input to the enjoyment of food and drink [4]. Although some studies have addressed the alterations of dietary behaviors in people with olfactory loss [5][6][7], relatively little is known about the perception of actual foods Y. Zang and P. Han equal contributions. 1 3 in this group. Hence, the current study was designed to study orthonasal and retronasal food odor perception as well as the taste of foods using foods familiar from real life. ...
Purpose
Eating-related problems are among the most frequent issues in olfactory impairment, causing a noticeable loss of quality of life for some of the affected persons. To what extent olfactory dysfunction impacts on the sensory perception of food is less explored. The aim of the present study was to examine the impact of olfactory dysfunction on the perception of food aromas, as well as the perception of the “basic tastes” salty, sour, sweet, and bitter.
Methods
Eighty-nine participants were recruited for the prospective study. Group 1 consisted of thoroughly examined patients with olfactory dysfunction (n = 48, mean age = 60.0 years), group 2 consisted of people with normal olfactory function (n = 41, mean age = 50.4 years). First, olfactory and gustatory functions were assessed for all participants with the help of the “Sniffin’Sticks” battery and the “taste strips” test. Second, food odors were rated for their pleasantness, intensity, familiarity and desirability. Last, real food items were tasted orally and the intensity for basic taste qualities (sweet, bitter, salty, and sour) and pleasantness was rated. In addition, salivation was measured following exposure to the food odors.
Results
In comparison to controls, patients rated orthonasal food odors as less pleasant, intense, familiar, and less appetizing. “Taste strip” scores were significantly lower in patients (M = 9.56, SD = 2.76) as compared to controls (M = 10.88, SD = 1.89). In addition, ratings of food liking for chocolate and peanut were lower in patients compared to controls (chocolate: patients—M = 6.85, SD = 2.09, controls—M = 7.90, SD = 1.53; peanut: patients—M = 4.88, SD = 2.20, controls—M = 6.80, SD = 2.33). No significant differences were found regarding the comparison of the salivary flow rate in controls (M = 0.52 g/min, SD = 0.19) and patients (M = 0.50 SD = 0.17).
Conclusions
Changes in the perception of odors may change the perception of food with specific effects on food liking. Olfactory dysfunction affects gustatory function, indicating the central-nervous interaction between taste and smell. Still, olfactory dysfunction did not appear to affect patients’ salivary flow.
... 7,8 Age-related declines in taste perception could cause limited dietary variety among older adults, 9 while lower olfaction sensitivity has been linked to lower nutritional intake. 10,11 They may also adjust their food values based on physiological changes in digestion. 7,8 Finally, Connors et al. 1 discovered that some individuals reprioritized their food values to accommodate changes related to age and illness. ...
This study investigated barriers to fulfilling food preferences from nursing home (NH) residents’ perspectives, and the reasons preferences changed (situational dependencies). Interviews were completed with 255 residents in 28 NHs across greater Philadelphia, PA using six food items from the Preferences for Everyday Living Inventory-NH (PELI-NH). Participants were predominantly white (77%), female (67.8%), and widowed (44%) with high school educations (48%). Content analysis was used to identify n = 386 barriers and n = 57 situational dependencies. Participants reported provider policies and staff proficiency as environmental barriers to preference fulfillment regarding what, when, and where to eat. Perceived health and personal resources were barriers to obtaining snacks, take-out, and dining out. Situational dependencies resulted from residents’ perceived health and quality of family relationships. Results have implications for providers to centralize food preference fulfillment in care planning, and to use food preferences to address dining quality concerns.
... Enfin, de nombreuses études ont montré que l'âge s'accompagne d'une altération des sens gustatif et olfactif, ce qui se traduit par un déclin de la capacité à percevoir les odeurs ou les saveurs des aliments [36][37][38][39][40]. Plusieurs auteurs ont montré que le déclin des capacités chimiosensorielles pouvait s'accompagner d'un déclin de l'appétit [41], de l'intérêt pour l'alimentation [42] ou de la variété alimentaire [43]. Toutefois, l'impact du déclin des capacités chimiosensorielles sur la prise alimentaire reste controversé à ce jour [41,44]. ...
Résumé
Le vieillissement est associé à de nombreux changements physiologiques, sensoriels, psychologiques et sociologiques susceptibles d’avoir un impact délétère sur la prise alimentaire et le statut nutritionnel de la personne âgée. La situation est particulièrement préoccupante en institution où une large majorité de personnes âgées ne satisfait pas à ses besoins caloriques et protidiques, notamment du fait d’une consommation insuffisante des plats protidiques servis au déjeuner et au dîner. Des relevés alimentaires réalisées en EHPAD ont montré que 83 % des résidents ne satisfaisaient pas à leurs besoins caloriques et protidiques (43 % présentaient un apport inférieur aux 2/3 des apports conseillés). Le maintien des apports protidiques et notamment de la consommation de viande en institution se heurte d’une part aux croyances des personnes âgées elles-mêmes (« Â mon âge, je n’ai plus besoin de manger autant de viande ! ») mais également à la maîtrise souvent difficile de la qualité des plats protidiques servis en restauration collective (assaisonnement, cuisson, maintien en température…).
... Following a review of the literature (Jones & Bartlett, 2018) and using relevant items selected from previous studies (Gopinath et al., 2014;Kremer, Holthuysen, & Boesveldt, 2014;Stevens et al., 2015), we designed a cross-sectional survey with 37 questions to evaluate the impact of visual impairment on nutritional status. The survey was designed to be administered over the telephone to a sample of people living with visual impairment in the United Kingdom. ...
Previous research has shown that people with visual impairment are more likely to be malnourished and have reported to have difficulty shopping for, preparing, and eating food. They are also reported to have a poor quality of life. The present study aims to investigate the impact of visual impairment on activities of daily living and Vision-Related Quality of Life (VR-QoL) in a sample of adults with visual impairment who are living in the United Kingdom.
A 37-question survey evaluating the nutritional status and the activities of daily living, cooking and shopping, was disseminated to adults with visual impairment who were 18 years and older. VR-QoL was also assessed using the validated, Questionnaire of Vision-Related Quality of Life Measure (VCM1).
Participants reported that being visually impaired made it difficult to shop for, prepare, and cook meals, and this correlated significantly with level of visual impairment. The VCM1 score of ⩾2.1 was reported by 74% of people with visual impairment revealing VR-QoL is more than a little of a concern for most of the participants. The mean VCM1 score for females was 2.9 ± 0.98 and 2.5 ± 1.1 for males. Level of visual impairment was not found to influence the VCM1 scores. This indicates even those with visual impairment below the level required for sight impairment registration report a reduced VR-QoL.
It is the responsibility and duty of society to support people with visual impairment or other disabilities rather than blaming them for not ‘integrating’. Among other things, this can be done by incorporating norms into the marketing. These norms might help to raise and increase the awareness of suppliers to the needs of consumers with visual impairment. Furthermore, such norms may contribute to our ongoing efforts for a more inclusive and accessible environment.
... Despite the fact that it is generally accepted that the olfactory system projects directly into cortical structures without first connecting in the thalamus, the thalamus does serve as an olfactory relay position between the entorhinal and orbitofrontal cortices. Studies have shown that there is no correlation between dysfunction of olfactory function and acceptance of flavor-enhanced foods (Kremer, Bult, Mojet, & Kroeze, 2007a;Kremer, Holthuysen, & Boesveldt, 2014), reflecting that modification in olfactory function can, but does not automatically, give rise to modification in dietary practice and nutritional status. ...
Elderly people avoid eating red meat and dried meat product due to its texture and stiffness; they deprive them of rich sources of nutrients. In addition, food-related diseases are exponentially increasing due to using synthetic additives in food products. Therefore, this research aimed to develop semi-dried goat meat jerky considering geriatric preferences by using natural tenderizers and nitrate. Four treatments were formulated negative control (NC [synthetic nitrite without tenderizers]), positive control (PC [Swiss chard without tenderizers]), T1 (Swiss chard with pineapple powder), and T2 (Swiss chard with pineapple and tomato powder). T1 and T2 had higher processing yield, and rehydration capacity compared with NC and PC. The fat content of T1 and T2 was lower than the control groups. Moisture was significantly higher in T1, NC, and T2 than in PC (p < 0.05). T2 showed the lowest water activity (0.87), lowest shear force (4.82 kgf), and lowest total plate count (TPC). The lowest pH and thiobarbituric acid reactive substances (TBARS) were observed in T1 and T2. T1 showed the lowest lightness and the maximum redness (p < 0.05) while PC showed the lowest yellowness. During the storage period, moisture and pH decreased, and TPC and TBARS significantly increased whereas water activity is stable regardless of the treatment. The results of the myofibrillar fragmentation index (MFI) and sodium dodecyl sulfate-polyacrylamide gel revealed that T1 and T2 more effectively converted protein to polypeptides. In addition, tenderizers positively affected thrombogenicity, atherogenicity, and hypocholesterolemic/hypercholesterolemic indices. T2 observed the highest overall sensory acceptance by reducing goaty flavor. Overall, jerky treated with tenderizers is easily chewable and digestible for the elderly due to its tenderness and essential fatty acids that would be senior-friendly food.
Consumers are preferring more “natural” foods, made of “healthier” and “familiar” components - the “clean-label” trend. As the population ages, understanding the older adult consumer segment becomes increasingly important. This study aims to identify the factors influencing the acceptability and liking of clean-label products in older adults living in the community. A convenience sample of 100 older adults was used for this cross-sectional study. Socio-demographic data, health status, independence level, lifestyle characteristics, nutritional status, and food and nutrient intake data were collected. The acceptability and liking for clean-label products comprised two parts: Sensory analysis with overall liking evaluation of three pairs of products, using a 9-point hedonic scale and free comments; Willingness to eat and preference assessment of nine pairs of products using the Food Action scale and a simple preference test. The participants were 80% female with a mean age of 75 years old. The overall liking for clean-label versions of cookies and mayonnaise was lower than for traditional versions. However, participants were more willing to eat the clean-label versions of products, particularly ham and yogurt. Most of the participants would prefer buying the clean-label version of all nine pairs of products, especially for ham, loaf bread, sausages, and yogurt. In sum, older adults living in the community exhibit a lower liking but, a greater willingness to eat and a higher preference for buying clean-label products. Older adults who favor clean-label products have higher levels of education and are reported to have a more adequate diet.
Smell is highly significant in how humans perceive food. Accordingly, olfactory disorders typically cause changes in patients’ feeding behaviour. Olfactory and gustatory dysfunction may significantly impair patients’ quality of life and alter the diet they choose to eat [1, 2]. The process of eating food consists of two principal stages, namely an anticipatory stage, wherein the food is seen and its aroma arouses orthonasal perception, and a consumption stage, where the food enters the mouth and any aroma is perceived in a retronasal fashion [3]. Everybody is familiar with the way a coryzal illness alters gustatory perception, and this experience illustrates how significant olfaction is for perceiving food or drink to be tasty [4]. Research has so far focused mainly on how individuals change their diet in response to olfactory dysfunction [5–7], rather than how food actually tastes to people in this situation [8]. Response inhibition is sensitive to unexpected changes in the environment triggered by emotional stimuli [9].KeywordsOlfactoryFeeding behaviourSatietyDietFood
Elderly people avoid eating red meat and dried meat product due to its texture and stiffness; they deprive them of rich sources of nutrients. In addition, food-related diseases are exponentially increasing due to using synthetic additives in food products. Therefore, this research aimed to develop semi-dried goat meat jerky considering geriatric preferences by using natural tenderizers and nitrate. Four treatments were formulated NC (synthetic nitrite without tenderizers), PC (Swiss chard without tenderizers), T1 (Swiss chard with pineapple powder), and T2 (Swiss chard with pineapple and tomato powder). T1 and T2 had higher processing yield, and rehydration capacity compared with NC and PC. The fat content of T1 and T2 was lower than the control groups. Moisture was significantly higher in T1, NC, and T2 than in PC (p<0.05). T2 showed the lowest water activity (0.87), lowest shear force (4.82 kgf), and lowest total plate count (TPC). The lowest pH and thiobarbituric acid reactive substances (TBARS) were observed in T1 and T2. T1 showed the lowest lightness and the maximum redness (p<0.05) while PC showed the lowest yellowness. During the storage period, moisture and pH decreased, and TPC and TBARS significantly increased whereas water activity is stable regardless of the treatment. The results of the myofibrillar fragmentation index (MFI) and SDS-PAGE gel revealed that T1 and T2 more effectively converted protein to polypeptides. In addition, tenderizers positively affected thrombogenicity, atherogenicity, and hypocholesterolemic/hypercholesterolemic indices. T2 observed the highest overall sensory acceptance by reducing goaty flavor. Overall, jerky treated with tenderizers is easily chewable and digestible for the elderly due to its tenderness and essential fatty acids that would be senior-friendly food.
Keywords: Swiss chard powder, tenderizers, goat meat jerky, goaty flavor, elderly people, dietary supplement.
Snacking is a common eating habit in the modern food environment. Individual snack choices vary substantially, with sweet versus savoury snacks linked to differential health outcomes. The role of olfactory and gustatory sensitivities in snack choices and consumption is yet to be tested. A total of 70 Caucasian young males (age: 21–39 years; BMI: 20.5–40.5 kg∙m−2) were tested for their supra-threshold sensitivities to sweet and savoury associated odours and tastants (vanillin, methional; sucrose, NaCl). The participants also attended an ad libitum task in which their intakes of sweet and savoury snacks were recorded and analysed. Univariate and multivariate analyses were used to test for relationships between odour/taste sensitivities and sweet versus savoury snack intake. Results indicated that individual sensitivities to sweet-associated stimuli (e.g., vanillin, sucrose) were negatively linked with intake of the congruent (e.g., sweet) snacks and positively linked with incongruent (e.g., savoury) snacks (p < 0.05). These differences were reflected by energy intake rather than consumption weight (p > 0.05). This study outlines the fundamental roles of olfactory and gustatory sensitivities in snack choices and offers novel insights into inter-individual variability in snack consumption.
Many older adults fail to meet their daily protein requirements, potentially due to social, physical and medical factors, including sensory and appetite changes. Additionally, our previous research has identified potential sulfurous off-flavours, originating from heat-treatment of protein ingredients, which could play a role in consumer acceptance. This study aims to determine the hedonic impact of these potential off-flavours when added to a dairy beverage, identify the specific off-flavour concentrations which cause rejection by consumers, and lastly investigate difference in acceptance between older and younger consumers. A rejection threshold (RjT) protocol was used, in combination with Best Estimate Thresholds (BET), whereby sulfurous flavours (dimethyl sulfide, dimethyl disulfide and dimethyl trisulfide), and diacetyl were added to create a range of concentrations. 95 participants (younger n=49, 18-38 years; older n=46, 60-79 years) tasted 7 pairs of samples (one blank and one with ascending off-flavour concentration) and selected their preferred samples. Sulfurous flavours negatively impacted consumer acceptance, however, the extent to which they impart a negative effect differs between age groups. Younger adults rejected samples containing low concentrations of sulfurous off-flavours (1.55 ppb), however, older adults rejected samples with concentrations over 3 times higher (5.08 ppb). When combined with sulfurous flavours, diacetyl increased the rejection threshold for both groups. In conclusion, these observations imply that a greater quantity of off-flavour may be present before acceptance is reduced in the older consumer group. Moreover, diacetyl demonstrates partial masking abilities of sulfurous off-flavours, and BET gave a more conservative estimate of acceptability. This knowledge will help guide sensory innovation of high-protein beverages for older consumers to support product acceptance and optimal intake.
The fine-tuned interplay between the brain and the body underlies the adaptive ability to respond appropriately in the changing environment. Mindfulness Disposition (MD) has been associated with efficient emotional functioning because of a better ability to feel engaged by information from the body and to notice subtle changes. This interoceptive ability is considered to shape the ability to respond to external stimuli, especially olfaction. However, few studies have evaluated the relationships between interoception and exteroception according to MD. We conducted an exploratory study among 76 healthy subjects for first investigating whether MD is associated with better exteroception and second for describing the causal interactions network between mindfulness, interoception, emotion, and subjective and objective olfaction assessments. Results found that a high level of MD defined by clustering exhibited best scores in positive emotions, interoception, and extra sensors' acuity. The causal network approach showed that the interactions between the interoception subscales differed according to the MD profiles. Moreover, interoception awareness is strongly connected with both the MD and the hedonic value of odors. Then, differences according to MD might provide arguments for a more mindful attention style toward interoceptive cues in relation to available exteroceptive information. This interaction might underlie positive health.
A decline in appetite and consequently in food intake is often observed with ageing, particularly in older adults living in nursing homes. Several strategies have been tested in nursing homes to counter this phenomenon. However, the approaches have rarely focused on food improvement, and most studies have assessed the impact of flavor enhancement on eating behavior. The present experiment aimed to assess the impact of improving sensory quality versus increasing sensory variety on food intake and meal enjoyment in elderly individuals living in a nursing home. Four conditions were compared: control condition, a Quality+ condition (recipes were improved according to sensory preference of the target population), a Variety+ condition (participants were offered a variety of main dishes and several condiments throughout the meal) and a Quality&Variety+ condition combining the two previous conditions. Eighty-two residents (age range: 71–101 years) participated in eight lunchtime sessions (2 replicates × 4 conditions). Compared to control condition, our results showed that improving the sensory quality of the dishes and/or providing variety led to increased meal enjoyment and food intake (energy intake: +5% for Quality+; +7% for Variety+). No additional effect was observed when the two factors were combined (+7% for Quality&Variety+). These results suggest that meal improvement strategies can be used to increase food intake in order to prevent and treat malnutrition in dependent older adults.
Care of older adults, including meal service to home-dwelling individuals is under pressure for improving its resource utilization. There is concern for potential meal quality impacts of this development – and subsequently for the users’ food intake and nutritional status. The objective of the study is to examine the municipalities’ additional costs of initiatives to improve quality in the supply of meal services for the home-dwelling elderly. An economic optimization model was developed and used to determine the cost-minimizing meal production scheme under alternative specifications regarding production methods, ingredient sourcing, composition of dishes, menu variation, and delivery frequency for each municipality in Denmark, while taking heterogeneity of users into account. Alternative modifications to the quality standards within these dimensions have been analyzed. Results suggest that except for higher delivery frequency, the additional costs of the considered quality improvements are modest (1–5% of the current cost), whereas daily delivery would increase the cost by 10–15% in several municipalities. Despite relatively low additional costs, Danish municipalities may lack the economic incentive to undertake such quality improvements, because the additional costs cannot be passed on to the users; thus, municipalities will need to finance these costs by savings on other municipal services.
Mit einer Riechstörung sind meist Konsequenzen für den Alltag, die Ernährung und die allgemeine Gesundheit der Patienten verbunden, die bisher nur in Ansätzen verstanden sind. Die Bagatellisierung einer Riech- oder Schmeckstörung sollte aber vermieden werden, um eine adäquate Abklärung in die Wege leiten zu können. Anamnese, HNO-Status, Bildgebung und zumindest eine Screening-Riechtestung sind dabei erforderlich. Als Therapieoptionen stehen in Abhängigkeit von der Ursache die topische oder systemische Kortisongabe, sowie das Riechtraining bei postinfektiöser und posttraumatischer Ursache zur Verfügung.
Purpose
The third age can be a period of major food consumption changes. Either voluntary or imposed by health issues, they may be accompanied by alterations in sensory acuity. This research investigated how lifelong food habits, health-age issues affect food choice at a later age, with the aim of developing strategies to direct aged people towards healthier food habits.
Design/methodology/approach
A survey, aimed to investigate differences between current and past food habits, was carried out in a group of 170 Italian older adults. Questions focused on the composition of the main meal, asking participants to describe its actual structure and to highlight differences in previous years’ food habits. A Discrete Choice Experiment (DCE) was planned, during which participants were asked to help formulating innovative pasta sauces with healthy ingredients.
Findings
This survey clearly illustrated gender-related differences: women were characterized by a higher consumption of vegetables, while men revealed a more frequent use of wine, pasta and meat. The DCE technique suited older adults’ abilities and enabled the development of innovative sauces, indicating a clear preference for extra-virgin olive oil, as compared to cream or butter. Gender-related differences were confirmed: women mainly chose a vegetarian sauce, while men expressed an inclination for red meat.
Originality/value
This is the first report of a successful application of DCE technique to investigate older adults’ dietary choices. The outspoken preference for olive oil as fat in sauce composition is a positive finding for future actions aimed at directing older adults towards healthier food habits.
Olfaction involves a dual sensory process for perceiving odors orthonasally (through the nostrils) and retronasally (through the mouth). This investigation entailed developing a measure of sensitivity to an odor delivered in an orally sampled food (orange flavoring in a sucrose-sweetened gelatin) and examining sensitivity in the elderly. In experiment 1, olfactory flavor sensitivity was 49 times lower in elderly (n = 21) than in young (n = 28) subjects. In experiment 2, with 73 elderly women, higher olfactory flavor sensitivity correlated significantly with higher orthonasal perception (Connecticut Chemosensory Clinical Research Center test). Some women, however, exhibited low olfactory flavor sensitivity despite high orthonasal perception; none had high olfactory flavor sensitivity and low orthonasal perception. Those who wore complete or palatal covering dentures had lower olfactory flavor sensitivity than those who were dentate or wore dentures that did not cover the palate. Through multiple regression analysis, orthonasal perception and denture status were found to be independent contributors to predicting olfactory flavor sensitivity. In summary, elderly subjects showed depressed olfactory flavor sensitivity (i.e. retronasal sensitivity) that related to poor orthonasal olfactory perception and denture characteristic. Thus, while good orthonasal olfaction may be necessary for good olfactory flavor sensitivity, it is not sufficient. Other factors, some associated with oral conditions, may impede release and retronasal transport of odors from the mouth to the olfactory receptors.
Objective:
This study investigates the association between MNA results and frailty status in community-dwelling older adults. In addition the relevance of singular MNA items and subscores in this regard was tested.
Design:
Cross-sectional study.
Setting:
Community-dwelling older adults were recruited in the region of Nürnberg, Germany.
Participants:
206 volunteers aged 75 years or older without cognitive impairment (Mini Mental State Examination >24 points), 66.0% female.
Measurements:
Frailty was defined according to Fried et al. as presence of three, pre-frailty as presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed. Malnutrition (<17 points) and the risk of malnutrition (17-23.5 points) were determined by MNA®.
Results:
15.1% of the participants were at risk of malnutrition, no participant was malnourished. 15.5 % were frail, 39.8% pre-frail and 44.7% non-frail. 46.9% of the frail, 12.2% of the pre-frail and 2.2% of the non-frail participants were at risk of malnutrition (p<0.001). Hence, 90% of those at risk of malnutrition were either pre-frail or frail. For the anthropometric, dietary, subjective and functional, but not for the general MNA subscore, frail participants scored significantly lower than pre-frail (p<0.01), and non-frail participants (p<0.01). Twelve of the 18 MNA items were also significantly associated with frailty (p<0.05).
Conclusions:
These results underline the close association between frailty syndrome and nutritional status in older persons. A profound understanding of the interdependency of these two geriatric concepts will represent the basis for successful treatment strategies.
Chemosensory acuity decreases with increasing chronological age, although not all senses decrease in acuity to the same extent. Through an improved understanding of the perceptual capabilities of the residual senses and the relative contribution each makes to an acceptance decision, it is possible to understand the sensory limitations of older consumers and devise compensation strategies to combat chemosensory loss.A commercially available orange juice was modified using aspartame, orange cells and capsaicin to provide varied levels of “sweetness”, “pulpiness” and “prickle/heat”. Perceptual differences for each attribute were established through studying concentration response functions using psychophysical techniques with a panel (N=20) of objective sensory assessors. These results were used to produce 18 orange juice samples, using a 3 × 3 × 2 factorial design of variations to the three stimuli, which were assessed using descriptive analysis by a panel (N=6) of trained sensory assessors. The resulting perceptual map of the product differences was used to select eight orange juice samples varied in “sweetness” (50, 400 ppm), “pulpiness” (0, 10% w/v) and “prickle” (0, 0.02 ppm) for acceptability testing with younger (N=48) and older (N=52) consumers. All participants were first tested for their sensitivity to sensory stimuli (taste, smell, irritation and texture perception). Participants were then requested to provide an overall measure of liking using a labelled affective magnitude scale. The acceptance measures showed differences between the two age groups as the younger assessors based their liking decisions on the predominant chemosensory attributes while the older assessors were more heterogeneous with some incorporating textural influences into their liking decision. To understand the attributes driving the liking the older assessors were divided into three groups based on their distribution on the preference map and partial least squares regression (PLS) was used to relate the sensory profile of the juices to the liking measures. Comparison of the groups revealed that the younger assessors selected against high aspartame and capsaicin levels, while the older assessors were more heterogeneous in their liking. Some of the older consumers that preferred higher levels of sensory stimulation (“sweetness” and “prickle”) tended to have lower sensitivity than the other groups across a range of sensitivity measures. The results show the diverse nature of the older consumer segment and demonstrate a possible role for increased textural and irritant sensation in compensating for chemosensory loss.
So-called functional foods are a new category of products that promise consumers improvements in targeted physiological functions. The objective of this study was to quantify the attitudes behind consumers' (n=1158) willingness to use these products. Functional food-related statements formed seven factors describing consumers' attitudes towards functional foods. These factors were as follows: perceived reward from using functional foods, confidence in functional foods, necessity for functional foods, functional foods as medicines, absence of nutritional risks in functional foods, functional foods as part of a healthy diet and the health effects of functional foods vs. their taste. These attitude subscales differentiated between consumers (n=1158) in their reported willingness to use functional foods. The best predictor for willingness to use functional foods was the perceived reward.
Bread is a major contributor to sodium intake in many countries. Reducing the salt (NaCl) content in bread might be an effective way to reduce overall sodium intake. The objectives of this study were to examine the effects of gradually lowering the salt content in brown bread, with and without flavor compensation (KCl and yeast extract), on bread consumption and sodium intake compensation by choice of sandwich fillings. A total of 116 participants (age: 21 ± 3 y; BMI: 22 ± 2 kg/m²) consumed a buffet-style breakfast on weekdays for 4 wk. Participants received either regular bread (control group: n = 39), bread whose salt content was gradually lowered each week by 0, 31, 52, and 67% (reduced group: n = 38), or bread whose salt content was also gradually lowered each week but which was also flavor compensated (compensated group: n = 39). A reduction of up to 52% of salt in bread did not lead to lower consumption of bread compared to the control (P = 0.57), whereas less bread was consumed when salt was reduced by 67% (P = 0.006). When bread was flavor compensated, however, a reduction of 67% did not lead to lower consumption (P = 0.69). Salt reduction in bread (with and without flavor compensation) did not induce sodium intake compensation (P = 0.31). In conclusion, a salt reduction of up to 52% in bread or even up to 67% in flavor-compensated bread neither affected bread consumption nor choice of sandwich fillings.
The effects of different types of product information on consumer product evaluation were examined in real life settings. Cod fillets were presented to 1440 consumers drawn from the Dutch TasteNet consumer panel for assessment in their own households. The product was presented accompanied by product information included in the package labelling. A control product, labelled simply as cod, was included. Consumers reported their evaluation of the product for overall and analytic sensory attributes. It was found that information about product type, price, freshness and the advantages of fish farming could influence product evaluation. Cod labelled as wild, highly priced or recently caught was judged more favourably than the unlabelled product. Information on the advantages of farming had a negative effect on product evaluation that interacted with price so as to minimise the positive effect of the latter. Interaction of the information provided with product perception in a realistic situation demonstrated that farmed fish was associated with less favourable product characteristics.
The impact of smell and taste disorders on dietary habits and nutritional status has received limited research attention. This paper reports findings obtained from questionnaires and diet records completed by 40 healthy subjects and 118 patients with chemosensory dysfunction. Chemosensory disorders were frequently associated with decreases in food acceptability. Although dietary responses to these dysfunctions varied greatly, patients with distorted or phantom smell and/or taste sensations tended to report weight loss whereas those with simple sensory loss were more likely to report weight gain. Indices derived from diet records did not indicate that either group of patients was at substantial nutritional risk, but food frequency responses and estimates of body mass index were consistent with patient reports of changes in dietary patterns and weight. In addition, marked weight change and aberrant dietary practices were noted in individual patients. Thus, there were indications that chemosensory dysfunction may be associated with nutritionally important dietary alterations.
The irreversible declines in taste and smell acuity that occur in many elderly persons can contribute to inadequate food intake and nutrition that are prevalent among the aged. Although chemosensory deficits cannot be reversed, previous studies have shown that the addition of intense flavors to foods can compensate for perceptual losses and improve food palatability and acceptance. In this study, the effect of sustained (3 week) flavor enhancement of typical institutional foods on the diet, health, and well being of 39 elderly (average age 84.6 SE 0.81 years) retirement-home residents was evaluated. For 3 weeks subjects ate an institutional diet (unenhanced). During another 3-week period, the same subjects ate identical foods to which intense flavors were added (enhanced). The 39 subjects were tested in two groups. For group 1 the unenhanced food period preceded the enhanced food period. For group 2, the order was reversed. Food intake was measured every weekday throughout the study, and the nutritional composition of the diet was analyzed. Biochemical measures of health status were obtained at the beginning of the study (baseline) and following both the unenhanced and enhanced periods. These measures included somatomedin-C/insulin-like growth factor I, transferrin, total T- and B-lymphocytes, and routine blood chemistries. Weight, height, midarm circumference, and triceps skinfold thickness were also measured. Handgrip strength and pinch strength were measured in group 1.(ABSTRACT TRUNCATED AT 250 WORDS)
Salts are used as flavouring agents in the cuisines of many cultures,
the most commonly used being NaCl. They impart their own salty taste and
enhance other flavours. The apparent ability to increase the intensity
of other desirable flavours is puzzling as virtually all published
psychophysical studies show that NaCl either suppresses or has no effect
on other flavours. To reconcile this contradiction we have proposed that
salts selectively filter flavours, such that unpleasant tastes (such as
bitterness) are more suppressed than palatable ones (such as sweetness)
thereby increasing the salience and/or intensity of the latter. We now
present evidence to support this idea.
To review the scientific literature on the alterations in the senses of taste and smell in the elderly, including causes, diagnosis, prognosis, and treatment.
Original reports and reviews obtained through MEDLINE searches from 1966 through June 1997 using the MeSH headings of "taste," "taste buds," "taste disorders," "taste thresholds," "smell," "odors," "aged," and "aging." Articles frequently cited in reference lists were also included.
All articles were reviewed, tabulated, and summarized.
Criteria for extraction included data quality and validity, statistical treatment of the data, venue of publication, and relevance to clinical care.
Losses of taste and smell are common in the elderly and result from normal aging, certain disease states (especially Alzheimer disease), medications, surgical interventions, and environmental exposure. Deficits in these chemical senses cannot only reduce the pleasure and comfort from food, but represent risk factors for nutritional and immune deficiencies as well as adherence to specific dietary regimens. Chemosensory decrements can lead to food poisoning or overexposure to environmentally hazardous chemicals that are otherwise detectable by taste and smell. Use of flavor-enhanced food can increase enjoyment of food and have a positive effect on food intake and immune status.
This study assessed the relation of an impaired taste and smell perception with (a) potential determinants and (b) nutritional
intake and status in elderly people. Determinants examined were age, gender, functional category (institutionalized vs independently
living), dental state, illnesses, smoking behavior, drug usage, and saliva excretion and composition. Nutritional intake and
status were measured by an “appetite and hunger” questionnaire, a food frequency questionnaire, and body mass index (BMI).
In order to have access to a large heterogeneous group, two different categories of elderly people were studied. We enrolled
independently living elders (n=89) assumed to have a relatively good taste and smell perception, and institutionalized elders (n=67) with a potential poorer taste and smell perception. Scores at the smell identification (range: 0–10) and taste perception
(range: 0–4) test were, respectively, 5.7 (independently living) versus 3.5 (institutionalized); p < .0001 and 3.3 versus 3.0; p < .05. Correlation between smell test scores and outcomes of the “appetite and hunger” questionnaire ranged from r: .19 to .50; p values < .05. There was, however, no clear correlation of any sensory outcome with energy and food intake, nor with BMI.
Regression analyses revealed that age and the functional category were the most important determinants of the scores on the
taste perception and smell indentification tests. It is concluded that a poor performance on sensory tests is related to a
poor appetite but not necessarily to low energy intake or low BMI. Age-related factors and smoking are important determinants
of impaired sensory functioning.
Olfaction involves a dual sensory process for perceiving odors orthonasally (through the nostrils) and retronasally (through the mouth). This investigation entailed developing a measure of sensitivity to an odor delivered in an orally sampled food (orange flavoring in a sucrose-sweetened gelatin) and examining sensitivity in the elderly. In experiment 1, olfactory flavor sensitivity was 49 times lower in elderly (n = 21) than in young (n = 28) subjects. In experiment 2, with 73 elderly women, higher olfactory flavor sensitivity correlated significantly with higher orthonasal perception (Connecticut Chemosensory Clinical Research Center test). Some women, however, exhibited low olfactory flavor sensitivity despite high orthonasal perception; none had high olfactory flavor sensitivity and low orthonasal perception. Those who wore complete or palatal covering dentures had lower olfactory flavor sensitivity than those who were dentate or wore dentures that did not cover the palate. Through multiple regression analysis, orthonasal perception and denture status were found to be independent contributors to predicting olfactory flavor sensitivity. In summary, elderly subjects showed depressed olfactory flavor sensitivity (i.e. retronasal sensitivity) that related to poor orthonasal olfactory perception and denture characteristic. Thus, while good orthonasal olfaction may be necessary for good olfactory flavor sensitivity, it is not sufficient. Other factors, some associated with oral conditions, may impede release and retronasal transport of odors from the mouth to the olfactory receptors.
There is a physiological decline in food intake with aging. The reasons for the decline in food intake are multifactorial
and involve both peripheral and central mechanisms. Altered hedonic qualities of food occur due to alterations in taste and,
more particularly, smell with aging. A decline in adaptive relaxation of the fundus of the stomach and an increased rate of
antral filling appear to play a role in the early satiation seen in many older persons. Cholecystokinin levels are increased
with aging and older persons are more sensitive to the satiating effects of this gut hormone. The decline in testosterone
levels in older males leads to increased leptin levels and this may explain the greater decline in food intake with aging
in the male. Within the hypothalamus, decreased activity of both the dynorphin (kappa opioid) and neuropeptide Y systems occurs
in aging rodents. Cytokines are potent anorectic agents. Many older persons have mild inflammatory disorders that lead to
anorexia. Exercise may increase food intake in older persons.
This article aims to provide an overview of the problems that exist in relation to malnutrition and the elderly population. The changes that occur in body composition during ageing are described and how this may affect disease risk. The possible metabolic processes behind weight loss are discussed and the numerous factors that affect nutritional status in the older age group are described. Prevention of malnutrition in this group is important and so the roles of nutrition screening and assessment are examined.
"Sniffin' Sticks" is a test of nasal chemosensory function that is based on pen-like odor dispensing devices, introduced some 10 years ago by Kobal and co-workers. It consists of tests for odor threshold, discrimination, and identification. Previous work established its test-retest reliability and validity. Results of the test are presented as "TDI score", the sum of results obtained for threshold, discrimination, and identification measures. While normative data have been established they are based on a relatively small number of subjects, especially with regard to subjects older than 55 years where data from only 30 healthy subjects have been used. The present study aimed to remedy this situation. Now data are available from 3,282 subjects as compared to data from 738 subjects published previously. Disregarding sex-related differences, the TDI score at the tenth percentile was 24.9 in subjects younger than 15 years, 30.3 for ages from 16 to 35 years, 27.3 for ages from 36 to 55 years, and 19.6 for subjects older than 55 years. Because the tenth percentile has been defined to separate hyposmia from normosmia, these data can be used as a guide to estimate individual olfactory ability in relation to subject's age. Absolute hyposmia was defined as the tenth percentile score of 16-35 year old subjects. Other than previous reports the present norms are also sex-differentiated with women outperforming men in the three olfactory tests. Further, the present data suggest specific changes of individual olfactory functions in relation to age, with odor thresholds declining most dramatically compared to odor discrimination and odor identification.
How cognition influences the affective brain representations of the taste and flavor of a food is important not only for understanding
top-down influences in the brain, but also in relation to the topical issues of appetite control and obesity. We found using
functional magnetic resonance imaging that activations related to the affective value of umami taste and flavor (as shown
by correlations with pleasantness ratings) in the orbitofrontal cortex were modulated by word-level descriptors. Affect-related
activations to taste were modulated in a region that receives from the orbitofrontal cortex, the pregenual cingulate cortex,
and to taste and flavor in another region that receives from the orbitofrontal cortex, the ventral striatum. Affect-related
cognitive modulations were not found in the insular taste cortex, where the intensity but not the pleasantness of the taste
was represented. We conclude that top-down language-level cognitive effects reach far down into the earliest cortical areas
that represent the appetitive value of taste and flavor. This is an important way in which cognition influences the neural
mechanisms that control appetite.
This study investigates the association between MNA results and frailty status in community-dwelling older adults. In addition the relevance of singular MNA items and subscores in this regard was tested. Cross-sectional study. Community-dwelling older adults were recruited in the region of Nurnberg, Germany. 206 volunteers aged 75 years or older without cognitive impairment (Mini Mental State Examination > 24 points), 66.0% female. Frailty was defined according to Fried et al. as presence of three, pre-frailty as presence of one or two of the following criteria: weight loss, exhaustion, low physical activity, low handgrip strength and slow walking speed. Malnutrition (< 17 points) and the risk of malnutrition (17-23.5 points) were determined by MNAA (R). 15.1% of the participants were at risk of malnutrition, no participant was malnourished. 15.5 % were frail, 39.8% pre-frail and 44.7% non-frail. 46.9% of the frail, 12.2% of the pre-frail and 2.2% of the non-frail participants were at risk of malnutrition (p < 0.001). Hence, 90% of those at risk of malnutrition were either pre-frail or frail. For the anthropometric, dietary, subjective and functional, but not for the general MNA subscore, frail participants scored significantly lower than pre-frail (p < 0.01), and non-frail participants (p < 0.01). Twelve of the 18 MNA items were also significantly associated with frailty (p < 0.05). These results underline the close association between frailty syndrome and nutritional status in older persons. A profound understanding of the interdependency of these two geriatric concepts will represent the basis for successful treatment strategies.
Sensory perception has been found to change during ageing. The perception of mouthfeel by older adults, and the role of ageing on the sensory perception of texture attributes is uncertain. This study investigated perception of the textural attributes of thickness, mouth coating and mouth drying, in the context of dairy beverages, by older and younger adults. Just noticeable differences of a starch thickener and for cream concentration within milk were established for thickness and mouth-coating perception, finding no age-related differences between participant groups. Mouth drying was assessed through the directional paired comparison of a mouth-drying milk beverage to a skimmed milk sample. The older adults were found to be more sensitive to mouth drying (P = 0.03) than the younger adults. This study found no age-related decline in texture perception with older adults finding perception of some attributes such as mouth drying enhanced by ageing.
Texture is an important attribute of food and beverages at any age. The decline of olfaction, flavor and taste perception with age may force older adults to put more emphasis on texture attributes; therefore, understanding the perception of textural cues in the mouth is very important. This study found texture perception of thickness, mouth coating and mouth drying may not only be preserved but in the case of mouth drying enhanced during ageing. This may impact on the enjoyment and consumption of foods of older adults, especially during illness or when taking medication. This research study is essential in showing the impact of ageing on texture perception and highlight to the food industry, hospitals and care homes the importance of texture attributes when developing foods and meals for older adults and patients.
Among factors contributing to malnutrition in the elderly, the present study aimed at assessing the impact of food selectivity (also referred as food “pickiness”) on the nutritional status of the elderly. A survey with 559 French people over 65 years old was conducted to collect data on food selectivity, dependency and nutritional status. Food selectivity was assessed by asking respondents to tick each food they dislike among a list of familiar foods. Since some foods could be ticked as disliked because elderly people experience physical difficulties in eating these foods, the survey also included self-report assessment about difficulties encountered when eating. Results showed that an increase of food selectivity is correlated with an increase of malnutrition risk, parallel to the effect of eating difficulties on malnutrition. It seems that the eating difficulties have a stronger impact on malnutrition than the food selectivity. However, the prevalence of food selectivity appears to be higher than the prevalence of eating difficulties. Furthermore, we observed that food selectivity increased as dependency increased. Given the fact that food selectivity may increase the risk of malnutrition, and that the number of “picky” eaters is far from being negligible in nursing homes, it seems worthwhile to screen for pickiness when elderly people become culinary dependent (delegation of food-related activities to a caregiver or a home helper, meal home-delivery by a catering service, nursing homes). It may give an opportunity to improve food care dedicated to these persons and in fine to prevent malnutrition.
Backgrounds & aims: Malnutrition in western health care involves a tremendous burden of illness. In this study the economic implications of malnutrition in Dutch nursing homes are investigated as part of the Health and Economic Impact of Malnutrition in Europe Study from the European Nutrition for Health Alliance. Methods: A questionnaire was developed, focussing on the additional time and resources spent to execute all relevant nutritional activities in nursing home patients with at risk of malnutrition or malnourished. Results were extrapolated on national level, based on the prevalence rates gathered within the national Prevalence Measurement of Care Problems 2009. Results: The normal nutritional costs are 319 million Euro per year. The total additional costs of managing the problem of malnutrition in Dutch nursing homes involve 279 million Euro per year and are related to extra efforts in nutritional screening, monitoring and treatment. The extra costs for managing nursing home residents at risk of malnutrition are 8000 euro per patient and 10000 euro for malnourished patients. Conclusions: The extra costs related to malnutrition are a considerable burden for the nursing home sector and urge for preventive measures.
Dietary intake changes during the course of aging. Normally an increase in food intake is observed around 55 years of age, which is followed by a reduction in food intake in individuals over 65 years of age. This reduction in dietary intake results in lowered levels of body fat and body weight, a phenomenon known as anorexia of aging. Anorexia of aging has a variety of consequences, including a decline in functional status, impaired muscle function, decreased bone mass, micronutrient deficiencies, reduced cognitive functions, increased hospital admission and even premature death. Several changes during lifetime have been implicated to play a role in the reduction in food intake and the development of anorexia of aging. These changes are both physiological, involving peripheral hormones, senses and central brain regulation and non-physiological, with differences in psychological and social factors. In the present review, we will focus on age-related changes in physiological and especially non-physiological factors, that play a role in the age-related changes in food intake and in the etiology of anorexia of aging. At the end we conclude with suggestions for future nutritional research to gain greater understanding of the development of anorexia of aging which could lead to earlier detection and better prevention.
This study investigates socio-demographic and attitudinal determinants of consumer willingness to compromise on taste for health in the specific case of the functional foods category. Cross-sectional consumer data were collected in Belgium from two socio-demographically comparable samples in 2001 and 2004 using a similar research method with personal interviews. Results show that the gap between acceptance of good versus worse tasting functional foods has widened significantly from 2001 to 2004. Whereas females and elderly were more ready to compromise on taste for health in 2001, any socio-demographic differences faded away in 2004. Health benefit belief from functional foods emerges as the strongest positive determinant of willingness to compromise on taste, but both its level and its predictive power on willingness to compromise on taste decreased over time. During the data collection interval, the perceived importance of food for health increased significantly. All evolutions combined are indicative for decreasing unconditional acceptance of functional foods, especially on taste, and a lower conviction that functional foods can constitute a part of a healthy and tasteful diet among a large majority of consumers. The conclusion is that counting on consumer willingness to compromise on the taste of functional foods for health is a highly speculative and risky strategic option.
The relationships between threshold sensitivity, supra-threshold intensity of NaCl, KCl, sucrose, aspartame, acetic acid, citric acid, caffeine, quinine HCl, monosodium glutamate (MSG) and inosine 5′-monophosphate (IMP), and the pleasantness of these stimuli in products, were studied in 21 young subjects (19–33 yr) and 21 older subjects (60–75 yr). For the young, threshold sensitivity was unrelated to supra-threshold intensity for all tastants and in all experimental conditions. For the elderly, in a few cases a relationship was found between threshold sensitivity and suprathreshold intensity, but only when subjects wore a nose clip. The optimally preferred concentration did not differ between the elderly and the young when the products were tasted without a nose clip, except for both sweet tastants, where elderly men showed a higher optimally preferred concentration than did the young. The optimally preferred concentration did not depend on the pleasantness of the foods and was unrelated to threshold sensitivity, but did show a negative correlation with the supra-threshold intensity of sucrose, aspartame and citric acid for the elderly and of NaCl, sucrose and caffeine for the young. This study does not support the assumption that age-related loss of taste sensitivity will inevitably lead to a preference for taste-enhanced foods.
Flavour perception has been rated as the strongest determinant of food choice in the elderly. Old age is often associated with inadequate nutritional status and diminished odour perception. Adjusting flavour to compensate for diminished odour perception may improve the quality of life for the increasingly older population. In this study, we test whether flavour amplification can induce changes in the consumption of particular food. The majority of the younger subjects prefer the low flavour soup, Quorn® and yoghurt, while the elderly subjects prefer the high flavour level soup, Quorn® and yoghurt. Comparing the consumed quantities of high and low flavour meals shows that for the younger subjects, flavour amplification decreases consumption levels of soup and yoghurt. For the elderly subjects, amplification of yoghurt increases consumed quantities. In conclusion, flavour amplification of food for the elderly deserves attention. Regular consumption of the products would improve nutritional status. Manipulation of flavour and other factors that determine the food choice of consumers in real life situations is a subject that deserves further study.
The sensory properties of foods and beverages are primary determinants of food choice. Some flavor components have an inherent hedonic valence that influences ingestive behavior. However, these hedonic impressions may be modified and others newly formed through their association with the post-ingestive consequences of food and beverage consumption. Flavor-active compounds, including spices, also modify digestive, absorptive and metabolic processes through direct activation of signaling pathways or via neurally-mediated cephalic phase responses. These may modify energy balance through effects on food digestion, energy absorption and metabolism. Thus, collectively, flavor has the potential to modify energy balance. Attempts to purposefully augment energy and nutrient intake have largely focused on the aging population where flavor fortification is posited to correct for diminishing sensory function. Evidence of efficacy is not strong, possibly due to methodological issues such as low statistical power and failure to match documented sensory limitations with the nature of the intervention. More rigorous testing should determine the viability of this therapeutic application of food flavors. The use of flavor compounds for weight reduction has yielded mixed results. Most trials have delivered the compounds via capsule precluding assessment of flavor to outcomes. Work with red pepper suggests there is an independent, albeit subtle, sensory effect on substrate oxidation coupled with a more general reduction of appetite and enhancement of energy expenditure. Flavor active compounds hold some promise for being more a part of the solution than the problem of disordered eating and unhealthy weight.
Malnutrition in western health care involves a tremendous burden of illness. In this study the economic implications of malnutrition in Dutch nursing homes are investigated as part of the Health and Economic Impact of Malnutrition in Europe Study from the European Nutrition for Health Alliance.
A questionnaire was developed, focussing on the additional time and resources spent to execute all relevant nutritional activities in nursing home patients with at risk of malnutrition or malnourished. Results were extrapolated on national level, based on the prevalence rates gathered within the national Prevalence Measurement of Care Problems 2009.
The normal nutritional costs are 319 million Euro per year. The total additional costs of managing the problem of malnutrition in Dutch nursing homes involve 279 million Euro per year and are related to extra efforts in nutritional screening, monitoring and treatment. The extra costs for managing nursing home residents at risk of malnutrition are 8000 euro per patient and 10000 euro for malnourished patients.
The extra costs related to malnutrition are a considerable burden for the nursing home sector and urge for preventive measures.
Obesity is currently a major public health concern; however, there is little data available on the prevalence and impact of obesity within the elderly population. This review examines the prevalence and health effects of obesity among individuals aged > or =50.
PubMed (1996-2008) and PsychInfo (2002-2008) search engines were used to retrieve qualified peer-reviewed articles focusing on obesity or a health condition correlated with obesity using BMI or other weight index as a defining variable; and studies limited to the elderly (age 60+) or pre-elderly (50+).
Worldwide, the elderly population is increasingly becoming obese regardless of socio-economic status. Among elderly persons, obesity increases the risks for a variety of morbidity conditions including cancers, diabetes, hypertension, stroke, heart disease, metabolic syndrome, obstructive sleep apnea syndrome, osteoarthritis, depression, disability, and lower scores on quality of life measures. In some reports, obesity has been linked to Alzheimer's disease and other forms of cognitive decline. Obesity significantly increases healthcare costs and nursing homes are currently ill equipped to address the needs of the rising number of obese residents.
Obesity is increasing in the elderly population worldwide and is expected to continue to rise. Obesity is associated with disease and disability in addition to escalating healthcare costs, and hospitals and nursing homes are ill equipped to serve the obese elderly. It is imperative that research efforts and funding be devoted to studying the effects and the reduction of obesity in the elderly population.
Previous research shows that modality-specific selective attention attenuates multisensory integration in healthy young adults. In addition, older adults evidence enhanced multisensory integration compared with younger adults. We hypothesized that these increases were because of changes in top-down suppression, and therefore older adults would show multisensory integration while selectively attending. Performance of older and younger adults was compared on a cued discrimination task. Older adults had greater multisensory integration than younger adults in all conditions, yet were still able to reduce integration using selective attention. This suggests that attentional processes are intact in older adults, but are unable to compensate for an overall increase in the amount of sensory processing during divided attention.